微创手术超囊经皮辅助全髋关节置换术。

Keisuke Hagio, Kazuhisa Aikawa
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摘要

背景和目的:微创手术技术在全髋关节置换术(THA)中的益处是众所周知的,但对在髋臼发育不良的继发性OA患者中应用SuperPATH的担忧尚未报道。我们的目的是评估SuperPATH是否适用于继发性OA,进一步量化下肢功能的恢复。方法:应用SuperPATH对30例因THA入院的继发性OA患者进行调查。临床日本骨科协会(JOA)评分及影像学评价。术前和术后早期检查以下情况;疼痛程度、血液检查、TUG和10m下肢恢复步行时间。结果:术前x线测量显示平均锐角为46.2±2.8度,CE角为19.4±7.3度。29例为Crowe I型,1例为Crowe II型。JOA评分从术前的48.8分提高到术后2个月的91.5分。围手术期疼痛评分(VAS)术前平均7.0±1.5分,术后第一天平均4.6±2.6分,术后2周逐渐降至1.2±1.4分。血液数据显示术后一天肌酸激酶、肌红蛋白和CRP显著升高,但术后2周恢复正常。术后1周TUG和10M步行时间均略高于术前,术后2周恢复至与术前相同水平。结论:我们的数据表明,SuperPATH入路THA治疗发育不良OA适用于轻度发育不良OA,并可实现下肢功能的早期恢复。
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Minimally invasive surgery supercapsular percutaneously-assisted total hip (SuperPath) arthroplasty.

Background and aim: The benefits of minimally invasive surgical techniques in total hip arthroplasty (THA) are well known, but concerns about applying SuperPATH in patients with secondary OA of acetabular dysplasia do not have been reported. We aim to evaluate whether SuperPATH is applicable to secondary OA, furthermore, to quantify the recovery of lower extremity function.

Methods: 30 patients with secondary OA admitted for THA applying SuperPATH were investigated. Clinical Japanese Orthopaedic Association (JOA) Score and radiographical evaluation were performed. Following was examined pre- and early post-operatively; pain level, blood tests, TUG and 10-M walking time for lower limb recovery.

Results: Preoperative radiographic measurements revealed an average Sharp angle of 46.2 ± 2.8 degrees and CE angle of 19.4 ± 7.3 degrees. 29 THAs had Crowe Type I and 1 THA had Crowe Type II. JOA score improved from 48.8 preoperatively to 91.5 at 2 months postoperatively. The perioperative pain assessment (VAS) averaged 7.0±1.5 preoperatively, 4.6±2.6 on the first postoperative day, then decreased gradually to 1.2±1.4 at 2 weeks. Blood data showed that creatine kinase, myoglobin, and CRP were significantly elevated on the day after surgery, but they normalized at 2 weeks postoperatively. Both TUG and 10M walking time showed slightly higher values at 1 week postoperatively compared to preoperatively but recovered to the same level as preoperatively at 2 weeks after surgery.

Conclusions: Our data suggests that SuperPATH approach to THA for dysplastic OA was applicable to mildly dysplastic OA and achieved an early recovery of lower limb function.

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来源期刊
Acta Biomedica de l''Ateneo Parmense
Acta Biomedica de l''Ateneo Parmense Medicine-Medicine (all)
CiteScore
4.30
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0.00%
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期刊介绍: Acta Bio Medica Atenei Parmensis is the official Journal of the Society of Medicine and Natural Sciences of Parma, and it is one of the few Italian Journals to be included in many excellent scientific data banks (i.e. MEDLINE). Acta Bio Medica was founded in 1887 and its founders and collaborators, Clinicians and Surgeons, entered history. Acta Bio Medica Atenei Parmensis publishes Original Articles, Commentaries, Review Articles, Case Reports of experimental and general Medicine. A section is devoted to a Continuous Medical Education programme in order to help primary care Physicians to improve the quality of care.
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