Fendri Khalil, Selmene Mohamed Amine, Kraiem Houssem Eddine, Bachar Malek, Zaraa Mourad, Chebbi Wael
Department of Orthopaedic Surgery and Traumatology, Trauma Centre, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, 1006, Tunis, Tunisia.
Tunis Med. 2025 Feb 5;103(2):250-254. doi: 10.62438/tunismed.v103i2.5416.
Total hip arthroplasty (THA) is an effective surgical procedure. Several surgical approaches have been described.
To compare postero-lateral and anterior approaches in terms of postoperative care, functional and radiological outcomes in patients undergoing primary THA surgery.
Patients undergoing primary THA were included in a retrospective descriptive study and divided into two groups according to surgical approach: anterior approach (AA) and postero-lateral approach (PLA). We compared demographic, perioperative data and functional outcome at 6 weeks and 6 months postoperatively according to Postel Merle d'Aubigné (PMA) and Harris (HHS) scores, radiological positioning of implants and postoperative complications.
Each group comprised 100 patients. In the AA group, operative time was shorter, patients had less pain, less bleeding and a shorter hospital stay, better PMA and Harris scores at six weeks post-operatively, with no difference at six months, better positioning of the acetabular cup, undersizing of the femoral stem and more iatrogenic fractures of the proximal femur. Patients in the PLA group had fewer skin and nerve complications and more prosthetic instability.
Current data do not demonstrate superiority of one approach over another in primary THA. We recommend the choice of surgical approach according to the patient's characteristics and surgeons' convictions.
全髋关节置换术(THA)是一种有效的外科手术。已经描述了几种手术入路。
比较初次全髋关节置换术患者后外侧入路和前入路在术后护理、功能及影像学结果方面的差异。
接受初次全髋关节置换术的患者纳入一项回顾性描述性研究,并根据手术入路分为两组:前入路(AA)和后外侧入路(PLA)。我们根据Postel Merle d'Aubigné(PMA)和Harris(HHS)评分、植入物的放射学定位及术后并发症,比较了两组患者的人口统计学、围手术期数据以及术后6周和6个月时的功能结果。
每组各有100例患者。在AA组中,手术时间较短,患者疼痛较轻、出血较少、住院时间较短,术后6周时PMA和Harris评分更好,6个月时无差异,髋臼杯位置更佳,股骨柄尺寸偏小,股骨近端医源性骨折更多。PLA组患者皮肤和神经并发症较少,假体不稳定更多。
目前的数据并未表明在初次全髋关节置换术中一种入路优于另一种入路。我们建议根据患者特征和外科医生的经验来选择手术入路。