改良微创前外侧入路全髋关节置换的初步结果

Preliminary outcomes of modified minimally invasive anterolateral approach for total hip arthroplasty

摘要:

[目的]探讨改良微创前外侧入路（orthopadische chirurgie munchen, OCM）在全髋关节置换中初步临床效果。[方法] 回顾性分析 2021 年 1 月—2023 年 1 月 32 例采用改良 OCM 入路行全髋关节置换术患者的临床资料，其中，男 12 例，女 20 例， 年龄平均（74.3±12.5）岁。评价临床及影像结果。[结果]所有患者顺利完成手术，手术时间平均（46.1±13.4）min，术中失血量平均（187.6±125.4）ml。患者随访平均（1.5±0.3）年，随时间推移，患者 VAS 评分 [(7.8±1.8), (2.6±0.3), (1.4±0.3), P＜0.001] 显著减少，而 Harris 评分 [(42.5±3.8), (81.2±4.2), (86.8±3.1), P＜0.001] 、髋伸屈 ROM [(86.3±7.2)°, (115.2±6.5)°, (130.3±7.1)°, P＜0.001] 显著增加。影像方面，32 例患者假体位置良好，与术后 3 个月相比，末次随访时髋臼前倾角和髋臼外翻角均无变化。[结论]改良 OCM 入路全髋关节置换术具有手术时间短、出血量少、并发症少等优点，临床疗效满意，是一种安全有效的手术入路。

Abstract:

[Objective] To investigate the preliminary clinical consequences of modified minimally invasive anterolateral (orthopa-dische chirurgie munchen, OCM) approach used for total hip arthroplasty (THA). [Methods] A retrospective study was done on 32 patients who had THA performed through the modified OCM approach from January 2021 to January 2023, including 12 males and 20 females with an average age of (74.3±12.5) years. The clinical and imaging data were evaluated. [Results] All patients were successfully operated with the average operation time of (46.1±13.4) min and the average intraoperative blood loss of (187.6±125.4) ml. With time of follow-up period lasted for (1.5±0.3) years in a mean, the VAS score [(7.8±1.8), (2.6±0.3), (1.4±0.3), P＜0.001] significantly reduced, while the Harris score [(42.5±3.8), (81.2±4.2), (86.8±3.1), P＜0.001], hip flexion-extension ROM [(86.3±7.2)°, (115.2±6.5)°, (130.3±7.1)°, P＜0.001] increased significantly. In term of imaging, all the 32 patients got prostheses in proper position, with no change in acetabular anteversion and acetabular abduction angle at the last follow-up compared with those 3 months after surgery. [Conclusion] This modified OCM approach for total hip arthroplasty has the advantages of short operation time, less blood loss, less complications with satisfactory clinical efficacy, and is a safe and effective surgical approach.