摘要
目的:比较采用直接前方入路(DAA)和髋关节后侧入路(Moore)行髋关节置换术(THA)治疗酒精性股骨头坏死的临床疗效。方法:回顾性分析2018年1月至2020年11月行THA治疗的57例酒精性股骨头坏死患者的临床资料,根据手术入路不同分为DAA组29例和Moore组28例,两组的年龄、性别、合并基础疾病情况比较,差异无统计学意义。比较两组患者的手术时长、术中出血量、髋关节Harris评分、美国特种外科医院(HSS)髋关节评分、Kawamura髋臼影像学评价。结果:DAA组手术时长为(86±12)min,与Moore组(90±7)min相近(t=-1.514,P>0.05);术中出血量DAA组100(100,150)ml比Moore组150(100,200)ml明显减少(Z=-2.465,P<0.05)。术后9个月两组患者的髋关节Harris评分、HSS髋关节评分、Kawamura髋臼影像学评估均较接近(P>0.05)。术后随访期间,DAA组无一例发生人工髋关节脱位;Moore组2例出现人工髋关节后脱位,分别发生于术后1.5个月和术后4个月,均予以牵引复位治疗。结论:对于酒精性股骨头坏死,采用DAA入路行THA可以有效降低术中出血量,髋关节功能恢复满意,术后髋关节脱位发生率低。
Objective:To analyze the efficacy of total hip arthroplasty(THA)through the direct anterior approach(DAA)and the posterior approach(Moore approach)in treatment of alcohol induced osteonecrosis of femoral head.Methods:Totally 57 patients with alcohol induced osteonecrosis of the femoral head receiving THA from January 2018 to November 2020 were enrolled in the study and divided into two groups as DAA group(n=29)and Moore group(n=28)by different approaches.There were no significant differences in age,gender and underlying diseases between the two groups.The operation time,intraoperative blood loss,hip joint Harris score,Hospital for Special Surgery(HSS)hip replacement score and Kawamura acetabular imaging evaluation were compared between the two groups.Results:The operation time of the DAAgroup was similar to that of the Moore group([86±12]min vs.[90±7]min,t=-1.514,P>0.05).The intraoperative blood loss was less in the DAA group than in the Moore group(100[100,150]ml vs.150[100,200]ml,Z=-2.465,P<0.05).The Harris score of the hip,HSS score and radiographic assessment of the acetabulum by Kawamura were closer in both groups when evaluated 9 months postoperatively(P>0.05).During the follow-up period,nobody suffered a hip dislocation in the DAA group;however,two patients in the Moore group developed posterior dislocations of the hips at 1.5 and 4 months after the operation respectively,and were both treated by traction reduction.Conclusions:The DAA approach for THA has the advantages of less intraoperative blood,satisfactory joint function recovery and lower rate of hip dislocation in treatment of the alcohol induced osteonecrosis of the femoral head.
作者
李凯
聂程
罗洪胜
LI Kai;NIE Cheng;LUO Hongsheng(Department of Orthopaedics,Yibin Second People's Hospital,Yibin 644000,Sichuan,China)
出处
《中华骨与关节外科杂志》
2022年第10期796-800,共5页
Chinese Journal of Bone and Joint Surgery
基金
宜宾市卫建委科研项目(2021yw0026)
关键词
股骨头坏死
关节成形术
置换
髋
酒精诱发性障碍
Osteonecrosis of Femoral Head
Arthroplasty,Replacement,Hip
Alcohol Induced Disorders
