西藏地区直接前入路髋关节置换的初步结果△

Preliminary results of direct anterior approach hip arthroplasty in Xizang area

摘要:

[目的] 探讨西藏地区直接前入路 （direct anterior approach, DAA） 髋关节置换术的初步结果。[方法] 回顾性分析 2023 年 8 月—2024 年 8 月西藏自治区人民医院收治的 23 例接受 DAA 髋关节置换术患者的临床资料，评价临床及影像结果。 [结果]23 例患者均顺利完成手术，术中无严重并发症。手术时间平均（109.4±32.5）min，切口长度平均（12.9±1.5）cm，术中失血量平均（317.4±148.9）mL。所有患者随访时间平均（13.5±1.2）个月，随术前、术后 3 个月和末次随访的时间推移，VAS 评分 [(9.1±0.6), (3.4±0.8), (2.1±0.5), P＜0.001] 显著减少，髋伸屈 ROM [(58.2±29.7)°, (117.0±8.6)°, (127.0±5.2)°, P＜0.001]、Harris 评分 [(31.5±18.2), (96.4±1.4), (96.7±2.1), P=0.010] 均显著增加。 影像方面，与术前相比，术后双下肢长度差、股骨颈干角、髋臼外翻角、髋臼前倾角均无显著变化（P＞0.05）。[结论]在西藏地区，DAA 髋关节置换术具有较好的初步结果，患者无脱位风险、恢复更快、满意度更高、髋关节功能更好。

Abstract:

[Objective] To investigate preliminary results of direct anterior approach (DAA) hip arthroplasty in Xizang area. [Methods] A retrospective study was done on 23 patients who received DAA hip arthroplasty from August 2023 to August 2024. The Clinical and imaging data were evaluated. [Results] The 23 patients were operated on successfully without serious complications, with the average operation time of (109.4±32.5) min, the average incision length of (12.9±1.5) cm, the average intraoperative blood loss of (317.4±148.9) mL. All the patients were followed up for a mean of (13.5±1.2) months. With time preoperatively, 3 months postoperatively and the latest follow-up, the VAS score was significantly decreased [(9.1±0.6), (3.4±0.8), (2.1±0.5), P＜0.001], while the hip flexion-extension range of motion (ROM) [(58.2±29.7)°, (117.0±8.6)°, (127.0±5.2)°, P＜0.001] and Harris score [(31.5±18.2), (96.4±1.4), (96.7±2.1), P=0.010] were significantly increased. As for imaging, there were no significant changes in the leg length discrepancy, femoral neck-shaft angle, acetabular abduction angle and acetabular anteversion after surgery compared with those before surgery (P＞0.05). [Conclusion] In Xizang, the DAA hip arthroplasty does achieve good initial clinical consequence, with advantages of less risk of dislocation, faster recovery, higher satisfaction, and better hip function recovery.