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中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (06) : 773 -780. doi: 10.3877/cma.j.issn.1674-134X.2021.06.022

微创关节技术

直接前方入路髋关节置换术的适应证和技术规范
冯尔宥1,(), 肖莉莉1, 沈凯魏1, 蓝艺萍1, 谢世伟1, 林飞太1, 翁艳1, 张怡元1   
  1. 1. 350000 福州,厦门大学附属福州第二医院关节外科
  • 收稿日期:2021-11-17 出版日期:2021-12-01
  • 通信作者: 冯尔宥

Indications and technical specifications for minimally invasive hip arthroplasty by direct anterior approach

Eryou Feng1(), Lili Xiao1, Kaiwei Shen1   

  • Received:2021-11-17 Published:2021-12-01
  • Corresponding author: Eryou Feng
引用本文:

冯尔宥, 肖莉莉, 沈凯魏, 蓝艺萍, 谢世伟, 林飞太, 翁艳, 张怡元. 直接前方入路髋关节置换术的适应证和技术规范[J]. 中华关节外科杂志(电子版), 2021, 15(06): 773-780.

Eryou Feng, Lili Xiao, Kaiwei Shen. Indications and technical specifications for minimally invasive hip arthroplasty by direct anterior approach[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(06): 773-780.

图1 DAA 9件套,弧形骨锉、6件Hoffman拉钩、骨钩,以及偏心持柄器
图2 手术床外观照。图A为手术床折叠前(上)和折叠后(下);图B为手术床增设臂板后,红色箭头为患侧增设臂板
图3 直接前方入路微创髋关节置换术(DAA-THA)手术切口外观照
图4 DAA-THA(直接前入路全髋关节置换术)髋臼侧显露示意图
图5 术中髋臼假体压配良好。图A为假体植入后术中透视;图B显示髋臼假体位置
图6 股骨开口显露及术中前倾角测量。图A股骨开口显露;图B蓝线(股骨颈后侧皮质平行线)与绿线(试体同侧平行线)夹角为术中测量前倾角;图C取出试体后股骨髓腔
图7 股骨显露及截骨术后
图8 CroweIV型DDH女性患者,56岁,行DA-THA粗隆下截骨术。图A、B为手术前髋关节正位及下肢全长位片,示左侧高位先天性髋关节脱位,下肢明显短缩;图C、D为手术后髋关节正位及下肢全长位片,示术中运用组配式假体(S-ROM),左侧髋关节旋转中心恢复,下肢短缩基本纠正
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