Iwakiri Kentaro, Ohta Yoichi, Minoda Yukihide, Ueno Shuhei, Kobayashi Akio, Nakamura Hiroaki
Department of Orthopaedic Surgery, Shiraniwa Hospital Joint Arthroplasty Center, 6-10-1 Shiraniwadai Ikoma- city, Nara, 630-0136, Japan.
Department of orthopaedic surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku, Osaka-city, Osaka, 545-8585, Japan.
Arch Orthop Trauma Surg. 2024 Dec 12;145(1):6. doi: 10.1007/s00402-024-05625-7.
In total hip arthroplasty (THA), soft tissue retraction is crucial, but traditional methods may cause damage. This study addresses the issue by introducing the Gripper Table Mounted System, a pulley-based retraction system. The research compares THA outcomes with and without the Gripper system, whether reducing soft tissue damage and postoperative pain. The Gripper, with its unique design, aims to minimize tissue damage during surgery.
The study conducted a retrospective analysis of 180 patients (180 hips) who underwent THA via an antero-lateral approach with the Gripper System or conventional retraction methods. Primary outcomes included gluteus medius cross-sectional area and hip abductor muscle strength. Secondary outcomes were pain VAS, intraoperative bleeding, operative time, laboratory data, and WOMAC score.
The study compared outcomes between those using the Gripper System (Gripper + group, n = 58) and those without (Gripper - group, n = 122). Both groups exhibited no significant differences in demographics or operative parameters. Gripper + group showed enhanced recovery in gluteus medius cross-sectional area and hip abductor muscle strength, with significant analgesia at various postoperative time points. No complications were noted in either group.
The Gripper system proved effective in early analgesia, swift recovery of hip strength, and preserving muscle area. Its single-use, sterile, and compact design offers advantages over traditional retractor holders or human assistance, potentially reducing soft tissue damage and postoperative pain. This study concluded the Gripper system's value in reducing pain and restoring strength in THA.
Therapeutic Level III.
The University Hospital Medical Information Network (UMIN) registration number UMIN000052948.
在全髋关节置换术（THA）中，软组织牵开至关重要，但传统方法可能会造成损伤。本研究通过引入一种基于滑轮的牵开系统——抓持器台式安装系统来解决这一问题。该研究比较了使用和不使用抓持器系统的THA结果，即是否减少了软组织损伤和术后疼痛。抓持器具有独特的设计，旨在将手术过程中的组织损伤降至最低。
本研究对180例患者（180髋）进行了回顾性分析，这些患者通过前外侧入路接受了使用抓持器系统或传统牵开方法的THA。主要结果包括臀中肌横截面积和髋外展肌力量。次要结果为疼痛视觉模拟评分（VAS）、术中出血、手术时间、实验室数据和西部安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。
该研究比较了使用抓持器系统的患者（抓持器+组，n = 58）和未使用抓持器系统的患者（抓持器-组，n = 122）的结果。两组在人口统计学或手术参数方面均无显著差异。抓持器+组在臀中肌横截面积和髋外展肌力量方面恢复更好，在术后不同时间点有显著的镇痛效果。两组均未发现并发症。
抓持器系统在早期镇痛、髋部力量快速恢复和保留肌肉面积方面被证明是有效的。其一次性使用、无菌且紧凑的设计比传统牵开器支架或人工辅助具有优势，可能减少软组织损伤和术后疼痛。本研究得出结论，抓持器系统在THA中对于减轻疼痛和恢复力量具有价值。
治疗性三级证据。
大学医院医学信息网络（UMIN）注册号UMIN000052948。
