仰臥位前方アプローチによる人工股関節全置換術での工夫

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  • A Useful Device for Total Hip Arthroplasty When Using the Direct Anterior Approach
  • ギョウガイ ゼンポウ アプローチ ニ ヨル ジンコウ コカンセツ ゼン チカンジュツ デ ノ クフウ

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Objective: We developed a new assist device which is useful for total hip arthroplasty (THA) when using the direct anterior approach (DAA). As the device can hold a retractor stably, we named it the “magic tower” (MT); it easily maintains excellent exposure.<br>Methods: A single surgeon performed 34 primary THAs in 33 patients between July 2008 and October 2009. We divided the patients into two groups: with or without the use of MT. The without MT group involved 18 hips and the with MT group involved 16 hips. We examined operating time, blood loss, length of skin incision, and inclination angle of the acetabular cup on X-ray examination.<br>Results: The mean operating time was 118.6 (94135) min in the without MT group and 104.5 (87135) min in with MT group. The mean blood loss was 233.6 (60400) g in the without MT group and 232.1 (60600) g in the with MT group. The mean length of skin incision was 85.0 (75100) mm in the without MT group and 79.9 (7390) mm in with MT group. The mean cup inclination was 47.3° (42°-53°) in the without MT group and 45.8° (40°-52°) in the with MT group. In all comparisons, there were no significant differences between the groups.<br>Conclusion: In primary THA using the DAA, there were no significant differences in the results between the with and without MT groups. However, MT obviously maintained excellent exposure and was a useful device in THA when using the DAA.

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