Çatma Mehmet Faruk, Yüksel Sinan, Yenidünya Mustafa Kemal, Kunu Orhan, Adıgüzel İbrahim Faruk, Ersan Önder
Ankara Etlik City Hospital, Ankara, Turkey.
Arch Orthop Trauma Surg. 2025 Jul 9;145(1):368. doi: 10.1007/s00402-025-05965-y.
The debate continues regarding the advantages of minimally invasive techniques in total hip arthroplasty (THA) compared to standard approaches. However, data on the use of minimally invasive approaches in dysplastic hips are limited. This study aims to compare the clinical, radiological, and functional outcomes of minimally invasive surgery (MIS) and standard surgery (SS) techniques in THA for Crowe type 2 dysplastic hips.
This retrospective, single-center study included 48 patients with Crowe type 2 dysplastic coxarthrosis who underwent primary THA between November 2022 and January 2024. Patients were divided into two groups based on the incision technique: MIS (n = 22) and SS (n = 23). Demographic data, intraoperative variables, and complications were recorded. Clinical evaluation included the Harris Hip Score (HHS), Berg Balance Scale (BBS), and Joint Position Sense (JPS) test at 3 months and 1-year follow-up. Radiological assessment involved component positioning, femoral offset, and leg length discrepancy.
The MIS group demonstrated significantly shorter incision length (8.5 cm vs. 14 cm; p < 0.001), reduced intraoperative blood loss (223.9 ml vs. 281.7 ml; p < 0.05), and shorter operative time (49.9 min vs. 58.8 min; p < 0.05) compared to the SS group. Both groups showed significant improvement in HHS at 3 months and 1-year follow-up. Early postoperative HHS, BBS, and JPS scores were significantly better in the MIS group at 3 months (p < 0.05), while no significant differences were observed between groups at 1-year follow-up. Radiological parameters, including component positioning and leg length discrepancy, were similar between groups, except for femoral offset, which was higher in the MIS group. No major complications, including dislocation, infection, or nerve injury, were observed in either group.
The MIS posterior approach in THA for Crowe type 2 dysplastic hips is a safe and effective technique providing advantages of reduced blood loss, shorter operative time, and smaller incision without component malposition or increased complication rates. Although early functional outcomes were better in the MIS group, the 1-year results were similar between the two techniques.
与标准方法相比，全髋关节置换术（THA）中微创技术的优势仍存在争议。然而，关于在发育不良髋关节中使用微创方法的数据有限。本研究旨在比较THA治疗Crowe 2型发育不良髋关节的微创手术（MIS）和标准手术（SS）技术的临床、放射学和功能结果。
这项回顾性单中心研究纳入了48例在2022年11月至2024年1月期间接受初次THA的Crowe 2型发育不良性髋关节炎患者。根据切口技术将患者分为两组：MIS组（n = 22）和SS组（n = 23）。记录人口统计学数据、术中变量和并发症。临床评估包括在3个月和1年随访时的Harris髋关节评分（HHS）、伯格平衡量表（BBS）和关节位置觉（JPS）测试。放射学评估包括假体位置、股骨偏心距和肢体长度差异。
与SS组相比，MIS组的切口长度明显更短（8.5 cm对14 cm；p < 0.001），术中失血量减少（223.9 ml对281.7 ml；p < 0.05），手术时间更短（49.9分钟对58.8分钟；p < 0.05）。两组在3个月和1年随访时HHS均有显著改善。术后3个月时，MIS组的早期HHS、BBS和JPS评分明显更好（p < 0.05），而在1年随访时两组之间未观察到显著差异。除股骨偏心距外，两组的放射学参数，包括假体位置和肢体长度差异相似，MIS组的股骨偏心距更高。两组均未观察到包括脱位、感染或神经损伤在内的重大并发症。
THA治疗Crowe 2型发育不良髋关节的MIS后外侧入路是一种安全有效的技术，具有减少失血量、缩短手术时间和较小切口的优点，且无假体位置不当或并发症发生率增加的情况。虽然MIS组的早期功能结果更好，但两种技术的1年结果相似。
