中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
4期
487-488
,共2页
髋关节置换术%关节囊修补%后外侧入路
髖關節置換術%關節囊脩補%後外側入路
관관절치환술%관절낭수보%후외측입로
Total hip arthroplasty%Capsulotendinous repair%Posterolateral approach
目的 探讨加强修补后方软组织预防行后外侧切口首次人工全髋关节置换术(THA)后早期脱位的临床疗效.方法 回顾性分析66例首次THA术中缝合后方完整的关节囊外旋短肌腱瓣至股骨大转子部分的患者术后早期脱位率.术中观察显示修补关节囊能够限制髋关节过度内旋,阻止股骨头假体在髋臼内衬内的初始滑动.结果 66例手术切口长度7 ～18 cm,平均14.5 cm；手术时间70～125 min,平均90 min；出血量210 ～ 650 ml,平均350 ml.无严重并发症.Harris评分优41例,良20例,中5例,优良率达92.4％ (61/66).66例随访24～60周(平均40周),无一例发生术后早期脱位.结论 在假体安放正确基础上,加强修补后方关节囊能够有效预防行后外侧切口首次THA术后早期脱位,THA术中保留关节囊,可减少手术创伤,重建髋关节软组织平衡,增加术后髋关节的稳定性,更好地恢复髋关节的功能.
目的 探討加彊脩補後方軟組織預防行後外側切口首次人工全髖關節置換術(THA)後早期脫位的臨床療效.方法 迴顧性分析66例首次THA術中縫閤後方完整的關節囊外鏇短肌腱瓣至股骨大轉子部分的患者術後早期脫位率.術中觀察顯示脩補關節囊能夠限製髖關節過度內鏇,阻止股骨頭假體在髖臼內襯內的初始滑動.結果 66例手術切口長度7 ～18 cm,平均14.5 cm；手術時間70～125 min,平均90 min；齣血量210 ～ 650 ml,平均350 ml.無嚴重併髮癥.Harris評分優41例,良20例,中5例,優良率達92.4％ (61/66).66例隨訪24～60週(平均40週),無一例髮生術後早期脫位.結論 在假體安放正確基礎上,加彊脩補後方關節囊能夠有效預防行後外側切口首次THA術後早期脫位,THA術中保留關節囊,可減少手術創傷,重建髖關節軟組織平衡,增加術後髖關節的穩定性,更好地恢複髖關節的功能.
목적 탐토가강수보후방연조직예방행후외측절구수차인공전관관절치환술(THA)후조기탈위적림상료효.방법 회고성분석66례수차THA술중봉합후방완정적관절낭외선단기건판지고골대전자부분적환자술후조기탈위솔.술중관찰현시수보관절낭능구한제관관절과도내선,조지고골두가체재관구내츤내적초시활동.결과 66례수술절구장도7 ～18 cm,평균14.5 cm；수술시간70～125 min,평균90 min；출혈량210 ～ 650 ml,평균350 ml.무엄중병발증.Harris평분우41례,량20례,중5례,우량솔체92.4％ (61/66).66례수방24～60주(평균40주),무일례발생술후조기탈위.결론 재가체안방정학기출상,가강수보후방관절낭능구유효예방행후외측절구수차THA술후조기탈위,THA술중보류관절낭,가감소수술창상,중건관관절연조직평형,증가술후관관절적은정성,경호지회복관관절적공능.
Objective To investigate the clinical results and significance and mechanism of early dislocation rate after total hip arthroplasty(THA) following the posterolateral approach with posterior capsuiotendinous repair.Methods The incidence of early dislocation among 66 consecutive primary THA with the posterior capsule and the short extend rotators sutured to the greater trochanter were reviewed.The repaired soft-tissue limited the excess internal rotation and the head initial slides in the polyethylene insert of acetabular component which was measured intraoperatively.Results During 24-60 weeks(40 weeks on average) follow-up,the patients with posterior capsulotendinous repair had no early posterior dislocation.Conclusion With the correct orientation of components and an enhanced capsulotendinous repair,the posterolateral approach can result in low early dislocation rate.Retaining articularis during primary THA can minimize operative trauma,reconstruct soft tissue balance and augment hip stability to get postoperative functional recovery.
