两种入路全髋关节置换术早期结果比较

Comparison of early results of two approaches for total hip arthroplasty

摘要:

［目的］ 直接前侧入路和前外侧入路全髋关节置换术的临床效果比较。［方法］ 回顾性分析 2018 年 1 月—2020 年 4 月在本院行全髋关节置换术 95 例患者的临床资料，其中，43 例采用直接前侧入路（前侧组），另外 52 例采用前外侧入路（前外侧组）。比较两组患者早期临床效果。［结果］两组患者均顺利完成手术。前侧组手术时间、术中出血量、切口长度、术后 1 d 和 2 d 时 1 min 步行距离，以及住院时间均显著优于前外侧组（P<0.05）。随时间推移，两组患者 Harris 评分均显著增加（P< 0.05）。术后 1 d，前侧组的 Harris 评分显著高于前外侧组（P<0.05），但术后 1、3 个月，两组间 Harris 评分差异无统计学意义 （P>0.05）。［结论］全髋关节置换直接前侧入路具有损伤小、恢复快的优点。

Abstract:

[Objective] To compare the clinical results of direct anterior approach (DAA) versus anterolateral approach (ALA) for total hip arthroplasty (THA) . [Methods] A total of 95 patients underwent total hip arthroplasty in our hospital from January 2018 to April 2020. Among them, 43 patients had THA performed through DAA, while the remaining 52 patients were through ALA. The early clinical out- comes were compared between the two groups. [Results] The operation was successfully completed in both groups. The DAA group was sig- nificantly superior to the ALA group in terms of operative time, intraoperative blood loss, incision length, 1 min walking distance at 1 day and 2days postoperatively, and hospital stay (P＜0.05) . The Harris scores increased significantly over time in both groups (P＜0.05) . At 1 and 3 months after surgery, the DAA group had significantly higher Harris score than the ALA group. [Conclusion] The direct anterior ap- proach for total hip arthroplasty has the advantages of minimizing iatrogenic trauma and enhancing recovery.