摘要 目的: 对比改良后方小切口入路(CH-DSA)与经皮辅助关节囊上方入路(supercapsular percutaneously-assisted total hip approach,SuperPATH)行初次全髋关节置换术后髋臼假体外展角与前倾角的差异。方法: 回顾性分析2019年1月至2021年1月诊断为单侧股骨颈骨折的201例患者,按照不同的手术入路分为CH-DSA组和SuperPATH组,对比两组患者围术期相关指标,测量术后双髋正位和患髋侧位X线平片对比髋臼杯的外展角和前倾角,以Lewinnek“安全区”为标准对比两个角度的可接受率。结果: CHDSA组手术时间明显短于SuperPATH组(P<0.001),切口长度明显长于SuperPATH组(P<0.001)。CH-DSA组外展角(43.54°±8.94°)明显大于SuperPATH组(40.66°±7.43°),差异有统计学意义(P=0.014);CH-DSA组外展角可接受率(71.0%)与SuperPATH组外展角可接受率(80.2%)无统计学差异(P>0.05)。CH-DSA组前倾角(16.81°±5.41°)明显大于SuperPATH组(10.69°±5.18°),差异有统计学意义(P<0.001);前倾角可接受率(94.0%)明显大于SuperPATH组(85.1%),差异有统计学意义(P<0.05)。结论: 两种入路的髋臼外展角可接受率无明显差异,CH-DSA入路前倾角的可接受率更高。
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