关键词: 髋关节, 关节置换, 微创, 后外侧切口, 应用解剖

Abstract:

        Objective: To provide anatomic evidences for minimally invasive surgery of total hip arthroplasty through the posterolateral approcach. Methods: Gluteal region of 30 adult specimens were dissected and observed. A line was drawn between the highest point of the greater trochanter of femur's lateral border (point A) and the point 3 cm ahead of the posterior superior iliac spine (point C), while the middle point of the AC line was taken as point B. The line between A and B was minimally invasive incision, with the length of 8.0 cm, for total hip arthroplasty through the posterolateral approach. The relevant anatomic features dealing with minimally invasive incision, including superior/inferior gluteal vessels and nerves and sciatic nerve were dissected and analyzed. Results: At the site of suprapitiform foramen, the distance between the superior gluteal vessels and nerves and the insicion was about (3.69±0.79)cm, however, at the site of infrapiriform foramen, the distance between the inferior gluteal vessels and nerves and the incision was (5.83±1.21)cm. The nearest distance from sciatic nerve to the incision below the infrapiriform foramen was about (4.09±0.66)cm. Conclusions: It is reliable to protect important nerves and vessels of gluteal area adopting minimally invasive posterior lateral approach. It is easy to locate bony markers during the operation.

Key words: hip, arthroplasty, minimal invasion, posterolateral approach, applied anatom