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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Comparison of primary total hip replacements performed with a direct anterior approach versus the standard lateral approach: perioperative findings
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Comparison of primary total hip replacements performed with a direct anterior approach versus the standard lateral approach: perioperative findings

机译：直接前路入路与标准侧位入路的主要全髋关节置换术比较：围手术期发现

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class="Heading">Background class="Para">Given the increasing demand for tissue-sparing surgery, the surgical approach is the subject of lively debate in total hip replacement. The aim of this paper is to compare the efficacy of the minimally invasive direct anterior approach and the standard lateral approach to total hip replacement surgery by observing intra- and perioperative outcomes. class="Heading">Materials and methods class="Para">The authors conducted a retrospective study on a group of 419 consecutive patients undergoing total hip replacement for coxarthrosis. The patients were divided into a first group (A) of 198 patients who had surgery with the standard lateral approach, and a second control group (B) of 221 patients who had the same procedure via the minimally invasive direct anterior approach. Assessment of the two groups considered the following perioperative parameters: length of the surgical procedure, intraoperative complications, intra- and postoperative blood loss, postoperative pain, postoperative nausea and vomiting, length of stay, and type of discharge. class="Heading">Results class="Para">The two groups were homogeneous when compared in relation to mean age, sex and body weight. The minimally invasive direct anterior approach was performed within an acceptable time (89?±?19?min vs. 81?±?15?min) and with modest blood loss (3.1?±?0.9?g/dL vs. 3,5?±?1?g/dL). Patients experienced less pain (1.4?±?1.5 NRS score vs. 2.5?±?2 NRS score), and PONV affected only 5% versus 10% of cases. Times to discharge were shorter (7?±?2?days vs. 10?±?3.5?days), and 58.4% versus 11.6% of patients were discharged to home. class="Heading">Conclusions class="Para">In our study, patients treated with a minimally invasive direct anterior approach had a better perioperative outcome than patients treated with the lateral approach. The longer time of surgery for the minimally invasive direct anterior approach may be attributed to the learning curve. Further studies are necessary to investigate the advantages of a minimally invasive direct anterior approach in terms of clinical results in the short and long run.
机译：class =“ Heading”>背景 class =“ Para”>鉴于对保留组织手术的需求不断增长，外科手术方法已成为全髋关节置换术中热烈争论的主题。本文的目的是通过观察术中和围手术期的结果，比较微创直接前入路和标准侧入路在全髋关节置换手术中的疗效。 class =“ Heading”>材料和方法 class =“ Para”>作者对一组419名接受髋关节置换术的连续患者进行了回顾性研究。将患者分为第一组（A）的198例接受标准侧位入路手术的患者，和第二对照组（B）的221例通过微创直接前路入路进行相同手术的患者。评估两组患者的围手术期参数包括：手术时间，术中并发症，术中和术后失血，术后疼痛，术后恶心和呕吐，住院时间和出院类型。 按平均年龄，性别和体重进行比较时，两组是同质的。在可接受的时间内（89？±？19？min vs. 81？±？15？min）进行微创直接前路入路，出血量适中（3.1？±？0.9？g / dL vs.3,5） ≤±≤1≤g/ dL）。患者的疼痛减轻程度较小（1.4？±？1.5 NRS评分与2.5？±？2 NRS评分），并且PONV仅影响5％而不是10％。出院时间更短（7？±？2？天vs. 10？±？3.5？天），并且58.4％比11.6％的病人出院了。 class =“ Heading”>结论 class =“ Para”>在我们的研究中，采用微创直接前入路治疗的患者围手术期结局优于采用侧入路治疗的患者。微创直接前路手术的更长的手术时间可能归因于学习曲线。从短期和长期的临床结果来看，有必要进一步研究微创直接前路手术的优势。

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