文献类型：期刊文献

英文题名：Using the anterior capsule of the hip joint to protect the tensor fascia lata muscle during direct anterior total hip arthroplasty: a randomized prospective trial

作者：Zhao, Gongyin[1];Zhu, Ruixia[1];Jiang, Shijie[1];Xu, Nanwei[1];Bao, Hongwei[2];Wang, Yuji[1,3,4,5]

第一作者：Zhao, Gongyin

通信作者：Wang, YJ[1];Wang, YJ[2];Wang, YJ[3];Wang, YJ[4]

机构：[1]Nanjing Med Univ, Affiliated Hosp, Changzhou Peoples Hosp 2, Dept Orthoped, Changzhou, Jiangsu, Peoples R China;[2]Jingjiang Peoples Hosp, Dept Orthoped, 28 Zhongzhou East Rd, Taizhou, Peoples R China;[3]Mayo Clin, Dept Orthoped Surg, 200 First St SW, Rochester, MN 55905 USA;[4]Mayo Clin, Dept Biochem & Mol Biol, 200 First St SW, Rochester, MN 55905 USA;[5]Gansu Univ Chinese Med, Affiliated Hosp 3, Dept Orthoped, 222 Silong Rd, Baiyin 730900, Peoples R China

第一机构：Nanjing Med Univ, Affiliated Hosp, Changzhou Peoples Hosp 2, Dept Orthoped, Changzhou, Jiangsu, Peoples R China

通信机构：[1]corresponding author), Nanjing Med Univ, Affiliated Hosp, Changzhou Peoples Hosp 2, Dept Orthoped, Changzhou, Jiangsu, Peoples R China;[2]corresponding author), Mayo Clin, Dept Orthoped Surg, 200 First St SW, Rochester, MN 55905 USA;[3]corresponding author), Mayo Clin, Dept Biochem & Mol Biol, 200 First St SW, Rochester, MN 55905 USA;[4]corresponding author), Gansu Univ Chinese Med, Affiliated Hosp 3, Dept Orthoped, 222 Silong Rd, Baiyin 730900, Peoples R China.|[10735]甘肃中医药大学;

年份：2020

卷号：21

期号：1

外文期刊名：BMC MUSCULOSKELETAL DISORDERS

收录：;Scopus(收录号：2-s2.0-85077765275);WOS:【SCI-EXPANDED(收录号:WOS:000514594800003)】；

基金：Social development fund of Jiangsu province, BE2015632 to Y.W. The fund provided financial support for patient follow-up and post-operative MR review, as well as assistance in data collection, statistics and language polishing.

语种：英文

外文关键词：Direct anterior approach; Total hip arthroplasty; Tensor fasciae lata muscle; Capsular; Protect; Trauma; Muscle cross-sectional area; Fatty atrophy

摘要：Background The direct anterior approach for total hip arthroplasty (THA) has specific advantages, but injury to the tensor fasciae lata muscle (TFLM) remains a concern. This injury in part negates some of the advantages of the intermuscular approach, because injury of the muscle fibers of the TFLM can lead to less satisfactory clinical results. Thus, in this study, we propose an intraoperative method to protect the TFLM and demonstrate its feasibility. Methods Fifty-six patients undergoing THA by the direct anterior approach were divided randomly into two groups. In group A, the TFLM was protected by an autogenous tissue "pad" created from the anterior capsule of the joint which protect the TFLM from direct contact with the retractors. In group B, the operation was carried out with no protection of the TFLM except the attempt by the surgeons to consciously avoid injury of the TFLM. We evaluated magnitude of changes in the muscle cross-sectional area (MSCA) and fatty atrophy (FA) by magnetic resonance imaging. The differences in blood hemoglobin and serum levels of myoglobin, lactate dehydrogenase (LDH), and creatine phosphokinase (CPK) were compared at different time, postoperatively. The Harris hip score, postoperative drainage volume and visual analogue scores (VAS) were compared between the two groups. Results LDH, CPK and myoglobin in group B were significantly higher than group A at 8, 24, and 48 h after the surgery. (p < 0.05) Compared to the group A, the decrease of hemoglobin in group B displayed significantly at 24 and 48 h after surgery. (P < 0.05) The significantly increased MSCA and FA of TFLM were demonstrated in group B. The PDV and VAS in group B were significantly higher than group A. (P < 0.05) The Harris score in group A was significantly higher than group B (P < 0.05) one month after surgery, but there was no significant difference six months later. Conclusions Using the anterior capsule of the hip joint as an autogenous, protective capsular tissue pad to limit the trauma to the TFLM during a direct anterior approach to THA is an effective method to protect the TFLM and improve the clinical effect.