Minimal-invasiver vs. transglutealer Hüftgelenkersatz

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• 作者：PD Dr. D. Wohlrab (1)
  J.-W. Droege (1)
  Dr. T. Mendel (1)
  Dr. K. Brehme (2)
  K. Riedl (1) (3)
  Prof. Dr. S. Leuchte (3)
  Prof. Dr. W. Hein (1)
  
• 关键词：MIS ; Minimal ; invasive Hüftendoprothetik ; Watson ; Jones ; Zugang ; HHS ; Weichteiltrauma ; MIS ; Minimally invasive THR ; Watson ; Jones approach ; HHS ; Soft tissue trauma
• 刊名：Der Orthop?de
• 出版年：2008
• 出版时间：November 2008
• 年：2008
• 卷：37
• 期：11
• 页码：1121-1126
• 全文大小：401KB
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• 作者单位：PD Dr. D. Wohlrab (1)
  J.-W. Droege (1)
  Dr. T. Mendel (1)
  Dr. K. Brehme (2)
  K. Riedl (1) (3)
  Prof. Dr. S. Leuchte (3)
  Prof. Dr. W. Hein (1)
  
  1. Zentrum für Erkrankungen der Haltungs- und Bewegungsorgane, Klinik und Poliklinik für Orthop?die, Martin-Luther-Universit?t Halle-Wittenberg, Magdeburger Stra?e 22, 06097, Halle, Deutschland
  2. Zentrum für Erkrankungen der Haltungs- und Bewegungsorgane, Klinik und Poliklinik für Unfallchirurgie, Martin-Luther-Universit?t Halle-Wittenberg, Halle, Deutschland
  3. Institut für Medien, Kommunikation und Sport, Department Sportwissenschaft, Martin-Luther-Universit?t Halle-Wittenberg, Halle, Deutschland
  

文摘

Background The aim of this prospective randomized study was to compare the results after total hip replacement (THR) using an MIS approach versus a regular transgluteal approach (Bauer approach). Method We compared 20 THRs using a modified Watson-Jones minimally invasive approach (MIS group) with 20 conventionally performed THRs using a Bauer approach (control group). In all cases, the same implants (Trilogy cup, MAYO stem) were used. The Harris Hip Score (HHS), the visual analogue scale, myoglobin level, and creatinine kinase level were measured preoperatively and up to 3 months postoperatively. Results Advantages of the MIS group were evaluated using the HHS in the categories of activity and range of motion 6 weeks postoperatively. In terms of function, gait, and total HHS, we found benefits in the MIS group 6 and 12 weeks postoperatively. Up to 48?h postoperatively, patients in the MIS group had lower myoglobin blood levels. No differences were found in creatinine kinase levels, pain sensation as measured by visual analogue scale, or implant positioning. Conclusion Use of the minimally invasive Watson-Jones approach shows advantages compared with the transgluteal Bauer approach 6 and 12 weeks postoperatively. Up to now there has been no prospective randomized clinical study that has definitely shown the superiority of the minimally invasive procedure. For that reason, the conventional approaches in THR are still the gold standard.