• 南京醫(yī)科大學(xué)附屬南京醫(yī)院(南京市第一醫(yī)院)骨科(南京,210006);

目的?通過與SL-PLUS標(biāo)準(zhǔn)假體比較,探討采用SL-PLUS MIA股骨柄假體行人工全髖關(guān)節(jié)置換術(shù)(total hip arthroplasty,THA)的近期療效。?方法?回顧分析2011年6月-12月采用SL-PLUS MIA股骨柄假體行THA的33例38髖患者(試驗組)臨床資料,并與同期35例40髖采用SL-PLUS 標(biāo)準(zhǔn)假體行THA的患者(對照組)比較。兩組患者性別、年齡、病程、病因及術(shù)前髖關(guān)節(jié)活動度、Harris評分比較,差異均無統(tǒng)計學(xué)意義(P  gt; 0.05),具有可比性。記錄兩組切口長度、手術(shù)時間及術(shù)中出血量,術(shù)后采用Harris評分評估髖關(guān)節(jié)功能改善情況,檢查髖關(guān)節(jié)活動度,復(fù)查X 線片了解假體位置。?結(jié)果?試驗組切口長度、手術(shù)時間均較對照組縮短,術(shù)中出血量亦顯著降低,差異均有統(tǒng)計學(xué)意義(P  lt; 0.05)。 術(shù)后兩組切口均Ⅰ期愈合。患者均獲隨訪,隨訪時間10~16個月,平均13.6個月。隨訪時對照組5例5 髖及試驗組3例3髖有髖關(guān)節(jié)疼痛不適表現(xiàn)。末次隨訪時,試驗組及對照組患者髖關(guān)節(jié)活動度分別為(152.48 ± 9.68)°及(152.16 ± 8.18)°、Harris評分分別為(91.4 ± 2.9)分及(90.9 ± 1.8)分,均較術(shù)前顯著提高(P  lt; 0.05);兩組間比較差異均無統(tǒng)計學(xué)意義(P  gt; 0.05)。X線片復(fù)查示兩組假體位置均良好,無移位、松動及下沉發(fā)生。?結(jié)論?與SL-PLUS 標(biāo)準(zhǔn)假 體比較,采用SL-PLUS MIA股骨柄假體行THA 具有手術(shù)創(chuàng)傷小、出血少的優(yōu)點,近期療效滿意,遠(yuǎn)期療效需進(jìn)一步觀察。

引用本文: 魏波,王黎明,金成哲,徐燕. SL-PLUS MIA股骨柄假體在人工全髖關(guān)節(jié)置換術(shù)中的初步應(yīng)用. 中國修復(fù)重建外科雜志, 2013, 27(3): 283-287. doi: 復(fù)制

1. Martin R, Clayson PE, Troussel S, et al. Anterolateral minimally invasive total hip arthroplasty: a prospective randomized controlled study with a follow-up of 1 year. J Arthroplasty, 2011, 26(8): 1362-1372.
2. Pflüger G, Junk-Jantsch S, Schöll V. Minimally invasive total hip replacement via the anterolateral approach in the supine position. Int Orthop, 2007, 31 Suppl 1: S7-11.
3. Roger DJ, Hill D. Minimally invasive total hip arthroplasty using a transpiriformis approach: a preliminary report. Clin Orthop Relat Res, 2012, 470(8): 2227-2234.
4. Sendtner E, Schuster T, Wörner M, et al. Accuracy of acetabular cup placement in computer-assisted, minimally-invasive THR in a lateral decubitus position. Int Orthop, 2011, 35(6): 809-815.
5. Labek G, Kovac S, Levasic V, et al. The outcome of the cementless tapered SL-Plus stem: an analysis of arthroplasty register data. Int Orthop, 2012, 36(6): 1149-1154.
6. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
7. Wenz JF, Gurkan I, Jibodh SR. Mini-incision total hip arthroplasty: a comparative assessment of perioperative outcomes. Orthopedics, 2002, 25(10): 1031-1043.
8. Barrack RL. The mini-incision: occasionally desirable, but rarely necessary. Orthopedics, 2004, 27(9): 936, 945.
9. Hallert O, Li Y, Brismar H, et al. The direct anterior approach: initial experience of a minimally invasive technique for total hip arthroplasty. J Orthop Surg Res, 2012, 7: 17.
10. Schleicher I, Haas H, Adams TS, et al. Minimal-invasive posterior approach for total hip arthroplasty versus standard lateral approach. Acta Orthop Belg, 2011, 77(4): 480-487.
11. 孫仕華, 王栓科, 趙琳, 等. 后外側(cè)入路傳統(tǒng)及微創(chuàng)人工全髖關(guān)節(jié)置換術(shù)對比研究. 中國修復(fù)重建外科雜志, 2009, 23(6): 641-643.
12. Yoon TR, Park KS, Song EK, et al. New two-incision minimally invasive total hip arthroplasty: comparison with the one-incision method. J Orthop Sci, 2009, 14(2): 155-160.
13. 張先龍, 沈灝, 畦述平, 等. 雙切口微創(chuàng)人工全髖關(guān)節(jié)置換術(shù). 中華骨科雜志, 2005, 25(5): 268-270.
14. Noble PC, Pflüger G, Junk-Jantsch S, et al. The optimal skin incision for minimally invasive total hip arthroplasty performed via the anterolateral approach. J Arthroplasty, 2012, 27(6): 901-908.
15. Bertin KC, Röttinger H. Anterolateral mini-incision hip replacement surgery: a modified Watson-Jones approach. Clin Orthop Relat Res, 2004, (429): 248-255.
16. 吳若, 徐耀增, 耿德春, 等. 改良Watson-Jones入路與改良Hardinge入路全髖關(guān)節(jié)置換術(shù)的療效比較. 中華創(chuàng)傷骨科雜志, 2011, 13(11): 1003-1007.
17. Waddell JP, Morton J, Schemitsch EH. The role of total hip replacement in intertrochanteric fractures of the femur. Clin Orthop Relat Res, 2004, (429): 49-53.
18. Sidhu AS, Singh AP, Singh AP, et al. Total hip replacement as primary treatment of unstable intertrochanteric fractures in elderly patients. Int Orthop, 2010, 34(6): 789-792.
19. Fan L, Dang X, Wang K. Comparison between bipolar hemiarthroplasty and total hip arthroplasty for unstable intertrochanteric fractures in elderly osteoporotic patients. PLoS One, 2012, 7(6): e39531.
  1. 1. Martin R, Clayson PE, Troussel S, et al. Anterolateral minimally invasive total hip arthroplasty: a prospective randomized controlled study with a follow-up of 1 year. J Arthroplasty, 2011, 26(8): 1362-1372.
  2. 2. Pflüger G, Junk-Jantsch S, Schöll V. Minimally invasive total hip replacement via the anterolateral approach in the supine position. Int Orthop, 2007, 31 Suppl 1: S7-11.
  3. 3. Roger DJ, Hill D. Minimally invasive total hip arthroplasty using a transpiriformis approach: a preliminary report. Clin Orthop Relat Res, 2012, 470(8): 2227-2234.
  4. 4. Sendtner E, Schuster T, Wörner M, et al. Accuracy of acetabular cup placement in computer-assisted, minimally-invasive THR in a lateral decubitus position. Int Orthop, 2011, 35(6): 809-815.
  5. 5. Labek G, Kovac S, Levasic V, et al. The outcome of the cementless tapered SL-Plus stem: an analysis of arthroplasty register data. Int Orthop, 2012, 36(6): 1149-1154.
  6. 6. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
  7. 7. Wenz JF, Gurkan I, Jibodh SR. Mini-incision total hip arthroplasty: a comparative assessment of perioperative outcomes. Orthopedics, 2002, 25(10): 1031-1043.
  8. 8. Barrack RL. The mini-incision: occasionally desirable, but rarely necessary. Orthopedics, 2004, 27(9): 936, 945.
  9. 9. Hallert O, Li Y, Brismar H, et al. The direct anterior approach: initial experience of a minimally invasive technique for total hip arthroplasty. J Orthop Surg Res, 2012, 7: 17.
  10. 10. Schleicher I, Haas H, Adams TS, et al. Minimal-invasive posterior approach for total hip arthroplasty versus standard lateral approach. Acta Orthop Belg, 2011, 77(4): 480-487.
  11. 11. 孫仕華, 王栓科, 趙琳, 等. 后外側(cè)入路傳統(tǒng)及微創(chuàng)人工全髖關(guān)節(jié)置換術(shù)對比研究. 中國修復(fù)重建外科雜志, 2009, 23(6): 641-643.
  12. 12. Yoon TR, Park KS, Song EK, et al. New two-incision minimally invasive total hip arthroplasty: comparison with the one-incision method. J Orthop Sci, 2009, 14(2): 155-160.
  13. 13. 張先龍, 沈灝, 畦述平, 等. 雙切口微創(chuàng)人工全髖關(guān)節(jié)置換術(shù). 中華骨科雜志, 2005, 25(5): 268-270.
  14. 14. Noble PC, Pflüger G, Junk-Jantsch S, et al. The optimal skin incision for minimally invasive total hip arthroplasty performed via the anterolateral approach. J Arthroplasty, 2012, 27(6): 901-908.
  15. 15. Bertin KC, Röttinger H. Anterolateral mini-incision hip replacement surgery: a modified Watson-Jones approach. Clin Orthop Relat Res, 2004, (429): 248-255.
  16. 16. 吳若, 徐耀增, 耿德春, 等. 改良Watson-Jones入路與改良Hardinge入路全髖關(guān)節(jié)置換術(shù)的療效比較. 中華創(chuàng)傷骨科雜志, 2011, 13(11): 1003-1007.
  17. 17. Waddell JP, Morton J, Schemitsch EH. The role of total hip replacement in intertrochanteric fractures of the femur. Clin Orthop Relat Res, 2004, (429): 49-53.
  18. 18. Sidhu AS, Singh AP, Singh AP, et al. Total hip replacement as primary treatment of unstable intertrochanteric fractures in elderly patients. Int Orthop, 2010, 34(6): 789-792.
  19. 19. Fan L, Dang X, Wang K. Comparison between bipolar hemiarthroplasty and total hip arthroplasty for unstable intertrochanteric fractures in elderly osteoporotic patients. PLoS One, 2012, 7(6): e39531.
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