临床外科杂志 ›› 2022, Vol. 30 ›› Issue (6): 592-595.doi: 10.3969/j.issn.1005-6483.2022.06.026

• 论著 • 上一篇    下一篇

臀中肌内侧间隙入路人工全髋关节置换术的临床观察

  

  1. 232052 安徽省淮南市新华医院关节外科(徐江发、汤磊、侯勇) ；安徽理工大学医学院临床医学院(崔英健)
  • 收稿日期:2021-12-31 接受日期:2021-12-31 出版日期:2022-06-20 发布日期:2022-06-20
  • 通讯作者: 侯勇，Email：13956409940@163.com

The clinical effect of total hip arthroplasty through the medial gluteus medius approach

  1. *Department of Orthopedics,Xinhua Hospital of Huainan City,Anhui,Huainan 232052，China
  • Received:2021-12-31 Accepted:2021-12-31 Online:2022-06-20 Published:2022-06-20

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摘要： 目的探讨臀中肌内侧间隙入路(medial gluteal medius approach，MGA)人工全髋关节置换术（THA）的临床效果。方法 2016年2月～2018年2月我院关节外科收治的THA住院病人72例，按入路方式分为两组，MGA组30例，采用MGA，后外侧入路THA(posterolateral approach，PLA)组42例，采用PLA入路。比较两组病人围手术期数据。结果 MGA组切口长度小于PLA组，首次行走时间早于PLA组，手术时间长于PLA组，两组比较差异有统计学意义(P＜0.05)。MGA组术后深静脉血栓1例，肌间静脉血栓5例；PLA组分别为4例，7例。PLA组2例病人发生假体后脱位，MGA组3例外展肌力较对侧减弱，术后3个月随访时基本恢复。术后1个月，MGA组Harris评分、SF-36评分优于PLA组，两组比较差异有统计学意义(P＜0.05)。两组术后前倾角和外展角比较，差异无统计学意义(P>0.05)。MGA组肢体长度差为(5.17±2.37)mm，PLA组为(4.26±1.91)mm，两组比较差异有统计学意义(P＜0.05)。结论 臀中肌内侧间隙入路全髋关节置换术创伤小,关节功能恢复快,并发症少。

关键词: 全髋关节置换术, 臀中肌内侧间隙入路, 后外侧入路, 生活质量

Abstract: Objective estigate the clinical effect of total hip arthroplasty(THA) through medius gluteus space approach(MGA).Methods The clinical data of 72 hospitalized THA patients in the Department of joint surgery of our hospital from February 2016 to February 2018 were analyzed retrospectively,including 30 cases of THA(medius gluteal space approach,MGA group),42 cases of THA(posterolateral approach,PLA group).Perioperative data of the two groups were compared.Results The incision length of MGA group was significantly shorter than that of PLA group,and the first walking time of MGA group was significantly earlier than that of PLA group，the operation time was longer than that of PLA group(P<0.05).There were 1 cases of deep venous thrombosis(DVT) in MGA group,5 cases with intermuscular venous thrombosis;and 4 cases DVT in PLA group,and 7 cases with intermuscular venous thrombosis.Postprosthetic dislocation occurred in 2 patients in PLA group,and abductor muscle strength in 3 patients in MGA group was weaker than that on the opposite side,and recovered at 3month follow-up.The postoperative Harris score and SF-36 score of the two groups were significantly higher than those before operation(P<0.001).1 month after operation,the Harris score and SF-36 score in MGA group were significantly better than those in PLA group(P<0.05).There was no significant difference in anteversion angle and abduction angle between the two groups(P>0.05).The limb length in MGA group was (5.17±2.37)mm,which was significantly higher than PLA group[(4.26±1.91)mm](P<0.05).Conclusion Total hip arthroplasty through the medial gluteus medius approach could achieve satisfactory clinical results,with less trauma.

Key words: total hip arthroplasty, medical gluteal medius approach, posterolateral approach, quality of life