Minimally Invasive Two-IncisionTotal Hip Replacement using large DiameterCeramic-on-Ceramic Articulation

摘要

Background: Our experience with the minimally invasive (Ml) two-incision technique over the last 4 years has shown that total hip arthroplasty (THA} can be performed safely and effectively in properly selected patients. Total hips with larger-diameter femoral heads are more resistant to dislocation. The purpose of the present study was to evaluate the short-term results of a minimally invasive two-incision THA Using Large Diameter Ceramic-on-Ceramic Articulation.Patients and Methods: A consecutive series of 50 patients who underwent unilateral Ml two-inicision THA from June 2006 to October 2006 were studied. There were 35 men and 15 women with a mean age at arthroplasty of 44.9 years (range, 23 to 73 years). There were 36 left and 14 right hip arthroplasties performed. Indications for THA were avascular necrosis of the femoral head in 29 cases, osteoarthritis in 12 cases, rheumatoid arthritis in 3 cases, femur neck fracture in 2 cases, dysplastic hips in 2 cases and ankylosing arthritis in 1 case. A modified two-incision approach was used for all procedures in lateral position, in-hospital data were collected retrospectively, and the initial postoperative radiographs were analyzed. Twenty-eight patients received 36 mm diameter femoral heads, while 22 patients received 32 mm diameter heads.Results: All patients could mobilize in the following days after surgery. There was no case of intraoperative complications such as intraoperative fracture, nerve palsy, or vascular injury. Postoperatively there was no dislocation or deep vein thrombosis. All femoral stems were inserted neutral or within 5 degree valgus. In all patients, leg length discrepancy was within 5mm difference. The average ROM of hips at last follow-up was significantly improved compared with the preoperative values.Conclusion: Short-term results of a minimally invasive two-incision THA using large diameter ceramic-on-ceramic articulation were excellent.