Abstract:Objective To compare the short-term clinical efficacy between the SuperPATH minimally invasive approach and the anterior lateral small incision.approach in total hip arthroplasty.Methods From Feb 2015 to Feb 2017,80 patients undrwent THA were involved.All cases were randomly divided into 2 groups.40 cases were treated by using SuperPATH approach as Super PATH group,while another 40 cases were treated by using anterolateral small incision approach as small incision group.The length of incision,operative time,intraoperative bleeding,postoperative drainage,hospitalization time,abduction angle and anteversion angle time were compared between the two groups.The visual pain analogue score(VAS)before operation and the VAS score of 1 day,days,1month and 3 months after operation and the Harris score of hip function before operation,and in 7 days,1 month and 6 months after operation were compared between the two groups.Results In SuperPATH group,the incision length was smaller than that of the anterior lateral small incision group(P<0.05);The hemorrhage,postoperative drainage and hospitalization time in SuperPATH group were less than those in the anterior lateral small incision group,and the difference was statistically significant(P<0.05),but SuperPATH group had longer operation time than the small incision group(P<0.05).Compared with the small incision group,the patient in the SuperPATH suffered less pain within 1day and 7days(P<0.05),similar pain in 1month and 3 months(P>0.05).The SuperPATH group's Harris hip score was increased significantly than small incision group from 7days,1 month and 3months after surgery(P<0.05),However,there was no significant difference in hip function between the two groups from 6 months after surgery(P>0.05).And there was no significant difference of abduction angle and angle of anteversion between 2 groups.Conclusion Both SuperPATH approach and anterolateral small incision approach can obtain good hip function in THA,but Super PATH approach can obtain a good joint stability,less trauma,faster postoperative recovery,but which influence on long-term effect needs further follow-up.
[1]秦啸龙,张先龙,周国民.前外侧肌间隙手术入路微创全髋关节置换术应用解剖学研究[J].中国临床解剖学杂志,2008,26(3):255-258.
[2]Gofton W,Chow J,Olsen KD,et al.Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique[J].Int Orthop,2015,39(5):847-851.
[3]Zhang X,Cheng T,Zeng B.Experts' consensus on minimally invasive surgery for total joint arthroplasty[J].Orthop Surg,2011,3(3):147-151.
[4]Xie J,Zhang H,Wang L,et al.Comparison of supercapsular percutaneously assisted approach total hip versus conventional posterior approach for total hip arthroplasty:a prospective,randomized controlled trial[J].J Orthop Surg Res,2017,12(1):138.
[5]Cronin MD,Gofton W,Erwin L,et al.Early surgical and functional outcomes comparison of the supercapsular percutaneously-assisted total hip and traditional posterior surgical techniques for total hip arthroplasty:protocol for a randomized,controlled study[J].Ann Transl Med,2015,3(21):335.
[6]黄宇,尹东,黄晓,等.前外侧小切口人工全髋关节置换术治疗成人髋臼发育不良的临床研究[J].中国临床新医学,2017,10(4):309-311.
[7]Wayne N,Stoewe R.Primary total hip arthroplasty:a comparison of the lateral Hardinge approach to an anterior mini-invasive approach[J].Orthop Rev(Pavia),2009,1(2):e27.
[8]Chow J,Penenberg B,Murphy S.Modified micro-superior percutaneously-assisted total hip:early experiences & case reports[J].Curr Rev Musculoskelet Med,2011,4(3):146-150.
[9]Penenberg BL,Bolling WS,Riley M.Percutaneously assisted total hip arthroplasty(PATH):a preliminary report[J].J Bone Joint Surg(Am),2008,90(Suppl 4):209-220.
[10]姚坚,丁海.SuperPATH微创人工全髋关节置换术的研究进展[J].中国修复重建外科杂志,2016,30(9):1170-1173.
[11]Rasuli KJ,Gofton W.Percutaneously assisted total hip(PATH)and Supercapsular percutaneously assisted total hip(SuperPATH)arthroplasty:learning curves and early outcomes[J].Ann Transl Med,2015,3(13):179.
[12]Della TP,Fitch DA,Chow JC.Supercapsular percutaneously-assisted total hip arthroplasty:radiographic outcomes and surgical technique[J].Ann Transl Med,2015,3(13):180.
[13]Noble PC,Johnston JD,Alexander JA,et al.Making minimally invasive THR safe:conclusions from biomechanical simulation and analysis[J].Int Orthop,2007,31(S1):25-28.