BACKGROUND: Now, domestic total hip arthroplasty (THA) surgeries are mainly traditional THA with posterolateral approach which has larger damage and slower recovery. Minimally invasive surgery is not popularization utilization, studies on minimally invasive THA with anterolateral approach are rarely and clinical randomized controlled trial studies are almost blank. OBJECTIVE: To compare the clinical effect of the minimally invasive THA with anterolateral approach and the traditional THA with posterolateral approach.METHODS: Totally 102 patients who treated with THA from Affiliated Wuxi People's Hospital of Nanjing Medical University from June 2008 to September 2009 were randomly divided into experimental group (n=55) and control group (n=47). The minimally invasive THA with anterolateral approach was used for the experimental group, and the traditional THA with posterolateral approach was used for the control group.RESULTS AND CONCLUSION: Compared with the control group, incision length, operation time were shorter, hemorrhage amount was less (P < 0.05), Harris score was higher at postoperative early stage (2 weeks, 3 months) in the experimental group (P < 0.05). There was no difference in the abduction angle of acetabulum cup and complications between the two groups (P > 0.05). Harris score in the two groups had no significant difference at postoperative six weeks and one year (P > 0.05). It is indicated that the minimally invasive THA with anterolateral approach is a safe and effective technique with the advantages of less surgical trauma, shorter operation time, fewer blood loss, slighter pain and rapid recovery of function.%背景:目前国内全髋关节置换以后外侧入路传统手术为主,损伤大,恢复慢,小切口手术未普及运用,前外侧小切口入路手术报道极少,临床RCT研究几乎空白.目的:对比前外侧小切口与传统后路切口全髋关节置换的临床疗效.方法:选择2008-06/2009-09在南京医科大学附属无锡人民医院行全髋关节置换的患者共102例,随机分实验组(n=55)和对照组(n=47),分别采用前外侧小切口和传统后路切口方法进行全髋关节置换.结果与结论:与对照组相比,实验组患者全髋关节置换的伤口小,手术时间短,术中出血少(P < 0.05),置换后早期(2周,3个月)Harris评分高(P < 0.05),但2组置换后髋臼外展角和不良事件发生率接近(P > 0.05),且置换后6个月,1年时Harris评分差异无显著性意义(P > 0.05).说明前外侧小切口全髋关节置换能在不影响临床疗效的前提下能够减轻手术创伤、缩短手术时间、减少出血、减轻置换后疼痛,置换后早期功能恢复快,是一种安全可靠有效的方法.
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