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中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 645 -650. doi: 10.3877/cma.j.issn.1674-134X.2021.05.021

微创关节技术

关节囊上方经皮辅助微创全髋关节置换手术步骤与技巧
李川1, 蒙旭晗2, 王斌3, 邢丹4, 浦路桥2, 卜鹏飞2, 唐志方2, 徐永清2,()   
  1. 1. 650032 昆明,解放军联勤保障部队第九二〇医院骨科;650504 昆明医科大学
    2. 650032 昆明,解放军联勤保障部队第九二〇医院骨科
    3. 030001 太原,山西医科大学第二医院骨科
    4. 2100044 北京大学人民医院骨关节科
  • 收稿日期:2021-09-13 出版日期:2021-10-01
  • 通信作者: 徐永清
  • 基金资助:
    云南省重大科技专项-生物医药重大专项(2018ZF008); 云南省卫健委临床中心建设重大项目(ZX20191001); 云南省科技厅两类人才培养项目(202005AD160146)

Surgical procedures and techniques of supercapsular percutaneously-assisted total hip arthroplasty

Chuan Li1, Xuhan Meng2, Bin Wang3   

  • Received:2021-09-13 Published:2021-10-01
引用本文:

李川, 蒙旭晗, 王斌, 邢丹, 浦路桥, 卜鹏飞, 唐志方, 徐永清. 关节囊上方经皮辅助微创全髋关节置换手术步骤与技巧[J]. 中华关节外科杂志(电子版), 2021, 15(05): 645-650.

Chuan Li, Xuhan Meng, Bin Wang. Surgical procedures and techniques of supercapsular percutaneously-assisted total hip arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(05): 645-650.

图1 SuperPATH术所需主要器械。图A为Cobb剥离器;图B为直角拉钩;图C为Zelpi撑开器;图D为关节囊撑开器;图E为髓腔铰刀(左)、干垢端铰刀(中)、髓腔测量器(右);图F为骨钩(上)、钝性穿刺器/T柄(下);图G为尖头(左)与钝头霍曼拉钩(右);图H为股骨距刮匙;图I为斯式针;图J为股骨距开孔器手柄及开口器;图K为PATH通道工具
图2 手术体位。图A为体位示意图;图B示患者取侧卧体位
图3 切口标记。图A为切口标记体表投影示意图;图B为术前SuperPATH入路切口标记
图4 显露关节囊并暴露梨状窝。图A为手术示意图;图B为术中显露关节囊
图5 股骨侧显露。图A~C示股骨侧髓腔、近端髓腔开道;图D~F示股骨头开口及股骨距内髓腔处理;图G示磨锉股骨髓腔至合适深度;图H示留置股骨髓腔锉作为股骨颈截骨导向器;图I示股骨颈截骨离断并取出股骨头
图6 髋臼侧处理过程。图A示a经皮辅助通道切口植入;图B~C示磨锉髋臼;图D为安装髋臼杯(上)、置入螺钉(下);图E为骨钩、T柄配合头颈试模合并与分离(上)T柄辅助关节复位(下);图F为h术中透视检查假体型号、角度、下肢长度等;图G~H原位或紧缩缝合关节囊;图I示闭合切口
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