최소침습 인공고관절 전치환술 - 단일절개와 두 부위 절개 -
Minimally Invasive Total Hip Arthroplasty
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초록
인공 고관절 전치환술에서도 적은 연부조직 손상, 적은 통증, 빠른 재활 및 미용적 측면 등의 이유로 최소 침습 인공 고관절 전 치환술에 대한 관심이 더욱 증가하고 있다. 수술 방법에 있어서는 단일 절개 방법과 두 부위 절개 방법이 있으며, 단일 절개는 최소 절개 방법 중 현재 가장 흔하게 사용되는 방법이다. 그중에서 주로 전외측, 후방 또는 후외측 도달법이 많이 사용되고 있으 며, 전통적인 절개에 비해 피부 절개를 크게 줄이는 효과를 가져 왔다. 두 부위 절개 방법은 피부 절개뿐만 아니라 근육 및 인대 의 손상을 최소화하려는 노력으로 Mears 와 Berger에 의해 소개 되었다. 이러한 최소 침습 수술 방법은 수술 시야확보가 어려 워 수술 중 합병증을 유발할 수 있는 가능성이 높고, 그러한 합병증을 예방하기 위해서는 충분한 고관절 수술 경험이 있는 시술 자가 알맞은 수술 기구의 구비 후 정확한 수술 수기를 습득한 후에 시행하는 것이 중요하다.
Abstract
Recently the interest in minimal invasive surgery for total hip arthroplasty is increasing due to its advantages of less soft tissue injury, less postoperative pain, early rehabilitation and cosmesis. There are two methods of minimal invasive surgery for total hip arthroplasty; one incision and two incision technique. The more common method is the one incision technique and among them, anterolateral and posterior or posterlateral method are most common. This one incision method reduces the length of incision. Two incision method was developed by Mears and Berger to reduce the degree of trauma to the muscles and tendons as well as to reduce the incision size. But the minimal invasive total hip arthroplasty has some potency of development of complications due to smaller operation field. So the minimal invasive total hip arthroplasty should be done only by experienced surgeons with sufficient training and adequate equiments.
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