Morrey B F, Adams R A, Cabanela M E
Clin Orthop Relat Res. 1984 Sep(188):160-7.
The effects of anterolateral, transtrochanteric, and posterior surgical approaches for total hip arthroplasty on heterotopic bone formation were studied in 507 consecutive patients with osteoarthritis or avascular necrosis who had not had previous hip surgery. Range of motion, degree of pain, and satisfaction were compared. Although the lowest incidence of ectopic ossification occurred after the posterior approach, there were no statistically significant differences among the three approaches. Extensive ectopic bone, involving more than half the distance between the trochanter and acetabulum, occurred in 29% after anterolateral, 28% after lateral transtrochanteric, and 22% after posterior approaches. Motion was most affected by the lateral approach, whereas relief of pain and general satisfaction were slightly better with the posterior approach. Multivariate statistical analysis suggests that the difference in results (p less than 0.05) with the posterior approach is primarily due to a relatively lower incidence of severe grades of heterotopic bone.
对507例未曾接受过髋关节手术的骨关节炎或缺血性坏死患者进行了研究，比较前外侧、经转子和后侧手术入路全髋关节置换术对异位骨形成的影响。比较了活动范围、疼痛程度和满意度。虽然后侧入路后异位骨化的发生率最低，但三种入路之间无统计学显著差异。广泛异位骨（累及转子与髋臼之间距离的一半以上）在前外侧入路后发生率为29%，经转子外侧入路后为28%，后侧入路后为22%。活动受外侧入路影响最大，而后侧入路在缓解疼痛和总体满意度方面略好。多变量统计分析表明，后侧入路结果的差异（p小于0.05）主要是由于严重程度的异位骨发生率相对较低。
