两种入路全髋关节置换术的早期结果比较

Comparison of early outcomes of two approaches for total hip arthroplasty

摘要:

[目的] 比较 SuperPATH 与后外侧入路 (posterolateral approach, PLA) 初次全髋关节置换术 (total hip arthroplasty, THA)的早期疗效。[方法]2018 年 7 月—2020 年 12 月，对 88 例患者行 THA。其中，45 例采用 SuperPATH 入路，其中 2 例术中改为后外侧入路，43 例纳入研究，43 例采用 PLA 入路。比较两组围手术期、随访和影像资料。[结果]SuperPATH 组切口长度、术后引流量、首次下地时间、住院时间均优于 PLA 组 (P＜0.05)。但 SuperPATH 组术中出血量、手术时间不及 PLA 组 (P＜0.05)。SuperPATH 组完全负重时间显著早于 PLA 组(P＜0.05)。术后 3 个月 SuperPATH 组 VAS 评分和 Harris 评分均显著优于 PLA 组，差异均有统计学意义(P＜0.05)，但末次随访时两组间上述评分的差异均无统计学意义(P＞0.05)。末次随访时两组髋臼外翻角差异无统计学意义(P＞0.05)，但 SuperPATH 组前倾角显著大于 PLA 组(P＜0.05)。[结论] 与 PLA 入路比较，Super- PATH 具有切口小、创伤小、疼痛轻、术后功能恢复快的优点，但手术时间较长。

Abstract:

[Objective] To compare the early outcomes of primary total hip arthroplasty (THA) through SuperPATH approach versus pos- terolateral approach (PLA) . [Methods] From July 2018 to December 2020, a total of 88 patients underwent primary THA in our hospital. Of them, 45 patients were undergoing THA through SuperPATH approach, however, 2 cases were changed to PLA intraoperatively, finally 43 cases were enrolled in the SuperPATH group, while 43 patients had THA by using PLA approach. The perioperative, follow-up and im- aging data were compared between the two groups. [Results] The SuperPATH group was superior to the PLA group in terms of incision length, postoperative drainage, time to return walking and hospital stay (P＜0.05) , whereas the former was inferior to the latter in intraopera- tive blood loss and operation time (P＜0.05) . The SuperPATH group resumed full-weight bearing activity significantly earlier than the PLA group (P＜0.05) . The SuperPATH group were significantly better than the PLA group in terms of the VAS and Harris scores at 3 months after surgery (P＜0.05) , whereas which became not statistical significant between the two groups at the latest follow-up (P＞0.05) . Regarding to ra- diographic assessment, there was no a significant difference in acetabular inclination between the two groups at the latest follow-up (P＞0.05) , but the anteversion angle of the SuperPATH group was significantly higher than that of the PLA group (P＜0.05) . [Conclusion] The Super- PATH has the advantages of smaller incision, less trauma, less pain and faster postoperative functional recovery, whereas longer operation time compared with PLA approach.