SL-PLUS MIA股骨柄假體在人工全髖關節置換術中的初步應用_《中國修復重建外科雜志》

作者：

魏波 , 王黎明 , 金成哲 , 徐燕

南京醫科大學附屬南京醫院（南京市第一醫院）骨科（南京，210006）;

關鍵詞：

人工全髖關節置換術 SL-PLUS MIA股骨柄假體 SL-PLUS標準假體微創手術

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目的?通過與SL-PLUS標準假體比較，探討采用SL-PLUS MIA股骨柄假體行人工全髖關節置換術（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 標準假體行THA的患者（對照組）比較。兩組患者性別、年齡、病程、病因及術前髖關節活動度、Harris評分比較，差異均無統計學意義（P gt; 0.05），具有可比性。記錄兩組切口長度、手術時間及術中出血量，術后采用Harris評分評估髖關節功能改善情況，檢查髖關節活動度，復查X 線片了解假體位置。?結果?試驗組切口長度、手術時間均較對照組縮短，術中出血量亦顯著降低，差異均有統計學意義（P lt; 0.05）。術后兩組切口均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髖有髖關節疼痛不適表現。末次隨訪時，試驗組及對照組患者髖關節活動度分別為（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，均較術前顯著提高（P lt; 0.05）；兩組間比較差異均無統計學意義（P gt; 0.05）。X線片復查示兩組假體位置均良好，無移位、松動及下沉發生。?結論?與SL-PLUS 標準假體比較，采用SL-PLUS MIA股骨柄假體行THA 具有手術創傷小、出血少的優點，近期療效滿意，遠期療效需進一步觀察。

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節置換術中的初步應用. 中國修復重建外科雜志, 2013, 27(3): 283-287. doi: 復制

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. 后外側入路傳統及微創人工全髖關節置換術對比研究. 中國修復重建外科雜志, 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. 雙切口微創人工全髖關節置換術. 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入路全髖關節置換術的療效比較. 中華創傷骨科雜志, 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. 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. 后外側入路傳統及微創人工全髖關節置換術對比研究. 中國修復重建外科雜志, 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. 雙切口微創人工全髖關節置換術. 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入路全髖關節置換術的療效比較. 中華創傷骨科雜志, 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.

《中國修復重建外科雜志》

SL-PLUS MIA股骨柄假體在人工全髖關節置換術中的初步應用

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《中國修復重建外科雜志》

SL-PLUS MIA股骨柄假體在人工全髖關節置換術中的初步應用

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