中国组织工程研究2019，Vol.23Issue(20)：3117-3123,7.DOI:10.3969/j.issn.2095-4344.1192
直接前侧入路全髋关节置换是否导致髋臼前壁偏心磨挫?
Whether direct anterior approach for total hip arthroplasty is a risk factor of eccentric reaming to the anterior column of the acetabulum?
摘要
Abstract
BACKGROUND:Direct anterior approach has been reported to be associated with a risk of reaming the anterior column of the acetabulum,but there is little evidence supporting this opinion.OBJECTIVE:To reveal differences in the bone stock of the anterior and posterior columns between the direct anterior approach and the posterolateral approach in total hip arthroplasty by CT measurement.METHODS:Sixty cases of primary total hip arthroplasty through direct anterior approach (n=30) or posterolateral approach (n=30) at Fuzhou Second Hospital of Xiamen University from October 2015 to December 2017 were enrolled.The cross-sectional area of the anterior and posterior column of the acetabulum,the height of the anterior and posterior column,acetabular diameter,and anteversion were measured by CT.All researchers had 5-10 years of clinical experience,and the surgeons were associate chief physicians or above.The trial has been approved by the Ethics Committee of Fuzhou Second Hospital of Xiamen University on June 1,2017.All patients signed the written informed consents.RESULTS AND CONCLUSION:(1) The postoperative cross-sectional area of the anterior and posterior column of the acetabulum,and the height of the anterior and posterior column in the two groups were less than those at baseline (P ＜ 0.05),the acetabular diameter was larger than that at baseline (P ＜ 0.01),and the anteversion showed no significant difference (P ＞ 0.05).The area of the anterior column in the direct anterior approach group was higher than that in the posterolateral approach group (P ＜ 0.05),and other parameters were insignificantly different between two groups (P ＞ 0.05).(2) in summary,compared with posterolateral approach in total hip arthroplasty,direct anterior approach leads to increased area of the anterior column,and made no effect on other parameters.Thereafter,direct anterior approach is not a risk factor for eccentric reaming the anterior column of acetabulum,and the conclusion needs to be confirmed by multicenter,prospective randomized controlled trials.关键词
髋臼前柱/前倾角/全髋关节置换/直接前侧入路/后外侧入路/股骨头坏死/危险因素/组织工程Key words
anterior column of the acetabulum/anteversion/total hip arthroplasty/direct anterior approach/posterolateral approach/femur head necrosis/risk factors/tissue engineering分类
医药卫生引用本文复制引用
苏联彬,冯尔宥,张怡元,卓有光,肖莉莉,王武炼,林飞太..直接前侧入路全髋关节置换是否导致髋臼前壁偏心磨挫?[J].中国组织工程研究,2019,23(20):3117-3123,7.基金项目
福建省自然科学基金(2017J01333),项目负责人:冯尔宥 the Natural Science Foundation of Fujian Province,No.2017J01333 (to FEY) （2017J01333）
