Analysis of the clinical efficacy of total hip replacement with SuperPATH approach in the treatment of femoral head necrosis

1.Department of Orthopedics, Shanxian Central Hospital shandongshanxian;2.Department of Orthopedics, Affiliated Hospital of Qingdao University shandong qingdao

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    目的:探讨SuperPATH入路与后外侧小切口全髋关节置换术治疗股骨头坏死术后疗效;方法:选取2017年6月~2019年6月我院收治的65例符合纳入标准的ONFH患者,均行THA术,常规组行后外侧小切口入路手术,研究组行SuperPATH入路手术,观察两组围术期一般指标、术后完全负重活动时间、术后随访6个月及末次随访VAS评分、Harris评分,观察术前、术后及末次随访髋臼外展角、前倾角、双侧肢体长度差异。结果:SuperPath组手术时间长,术后首次下床行走时间及住院时间缩短,切口短,差异有统计学意义(P<0.05),术中失血无统计学意义(P>0.05); 负重时间SuperPath组明显优于PLA组(P<0.05),两组术前VAS评分及Harris评分比较差异无统计学意义(P>0.05),两组术后VAS评分均逐渐降低,Harris评分逐渐增加,术后6月VAS评分及Harris评分比较差异有统计学意义(P<0.05),但末次随访时VAS评分及Harris评分比较差异无统计学意义(P>0.05)。两组术前及术后末次随访髋臼外展角,髋臼前倾角比较差异均无统计学意义(P>0.05)。术前及术后两组肢体长度差无统计学意义(P>0.05),但两组术后肢体长度差较术前明显缩短,差异有统计学意义(P<0.05)。结论:SuperPATH入路THA术中组织损伤小,患者早期康复迅速,减轻患者疼痛症状,促进髋关节功能恢复,可作为ONFH治疗的可靠术式。


    Abstract Objective:To explore the curative effect of SuperPATH approach and posterolateral small incision total hip arthroplasty for the treatment of femoral head necrosis; Method: 65 patients with ONFH who met the inclusion criteria were selected from June 2017 to June 2019 in our hospital, all underwent THA After surgery, the conventional group received small-incision posterior lateral surgery, and the research group received SuperPATH surgery. The general perioperative indicators, postoperative full weight-bearing activity time, postoperative follow-up 6 months, and last follow-up VAS score, Harris were observed in the two groups. Score, observe the difference of acetabular abduction angle, anteversion angle, and bilateral limb length before operation, after operation and at the last follow-up. Results: In the SuperPath group, the operation time was long, the first time to get out of bed and the hospital stay after the operation were shortened, the incision was short, the difference was statistically significant (P<0.05), and the intraoperative blood loss was not statistically significant (P>0.05); Weight-bearing time SuperPath The group was significantly better than the PLA group (P<0.05). There was no significant difference in the preoperative VAS score and Harris score between the two groups (P>0.05). The VAS scores of the two groups gradually decreased after the operation, and the Harris score gradually increased. The difference between VAS score and Harris score in June was statistically significant (P<0.05), but there was no significant difference between VAS score and Harris score at the last follow-up (P>0.05). There was no significant difference in acetabular abduction angle and anteversion angle between the two groups before and at the last follow-up after operation (P>0.05). The limb length difference between the two groups before and after operation was not statistically significant (P>0.05), but the difference in limb length after surgery was significantly shorter than that before operation, and the difference was statistically significant (P<0.05). Conclusion: The SuperPATH approach has little tissue damage during THA operation, and the patient recovers quickly in the early stage, relieves the pain symptoms of the patient, and promotes the recovery of hip joint function. It can be used as a reliable surgical method for the treatment of ONFH.

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  • 收稿日期:2021-04-20
  • 最后修改日期:2021-10-05
  • 录用日期:2021-12-02
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