Objective To study the efficacy and complications of mini-incision total hip arthroplasty (THA) compared with conventional approach THA. Methods From November 2004 to June 2009, 38 patients (40 hips) received THA using the modified posterolateral mini-incision approach (6-10 cm) and 47 patients (48 hips) received THA using conventional approach (11-15 cm). All the surgery were performed by the same surgeon. Results The mean duration of follow-up was 21.2 months (range, 18-24). No infection, prosthetic dislocation or nerve injury was occurred in either group. Two cases had superficial wound scratches in mini-incision group, and in conventional group one patient had deep venous thrombosis. The mean operation time of mini-incision group and conventional group was 72 minutes (range, 60-100) vs 69 minutes (range, 70-175), and blood loss averaged 350 ml (range, 250-520) vs 393 ml (range, 270-600), there was no statistical difference (P>0.05). The mean length of skin incision of mini-incision group and conventional group was 9.2 cm (range, 6.8-10) vs 16.4 cm (range, 14-24), and the mean postoperative 12-hour drainage flow was 211 ml (range, 120-300) vs 249 ml (range, 140-400), and hospitalization time was mean 6.6 days vs 7.5 days. The differences between groups were statistically significant (P<0. 05). The visual analogue scale (.VAS) of the first three days after surgery were 4.0, 3.1 and 2. 3 in mini-incision group vs 4. 6, 3. 7 and 2. 4 in conventional group. The mean Harris hip score after 1 and 3 months was 90.5 and 91.1 in mini-incision group vs 88.2 and 91.2 in conventional group. There was no difference in functional or radiographic results. Conclusion The posterolateral mini-incision approach THA can minimize surgical trauma to the soft tissues, shorten hospitalization time, reduce postoperative pain and improve rehabilitation compared with the conventional approach THA in appropriate indication.%目的 比较后外侧小切口全髋关节置换术(THA)与传统THA的临床疗效及并发症.方法 2004年11月至2009年6月,对38例(40髋)患者行后外侧小切口(6～10 cm)THA,47例(48髋)患者行传统切口(11～15 cm)THA.所有病例均由同一位主刀医生完成手术.结果 术后随访平均21.2个月(18～24个月),两组病例均未出现感染,假体脱位及神经损伤等并发症,小切口THA组有2例患者术中发生切口近端皮肤擦伤,传统THA组有1例患者术后发生深静脉血栓.小切口THA组和传统THA组手术时间分别为72(60～100)min和69(70-175)min,术中出血量分别为350(250～520)ml和393(270～600)ml,差异均无统计学意义(P>0.05);手术切口分别为9.2(6.8～10)cm和16.4(14～24)cm,术后12h引流量分别为211(120～300)ml和249(140～400)ml,平均住院时间分别为6.6 d和7.5 d,差异均有统计学意义(P<0.05);术后第1、2,3天疼痛视觉模拟评分(VAS)分别为4.0分、3.1分、2.3分和4.6分、3.7分、2.4分,术后1、3个月Harris评分分别为90.5分、91.1分和88.2分、91.2分.术后影像学表现无统计学差异.结论 后外侧小切口THA在适宜手术适应证前提下与传统THA相比,具有减少软组织损伤、缩短住院时间、减轻术后疼痛和加快术后康复的优势.
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