Kuhfuss W, Schildhauer M, Tönnis D
Z Orthop Ihre Grenzgeb. 1975 Jun;113(3):316-22.
The functional results of total hip prosthesis are influenced significantly by the tension given to the glutaeus medium muscle at operation. Low tension may result in a limp (positive Trendelenburg sign), high tension may decrease movement. In 206 cases of total hip replacement the Trendelenburg sign (grades from 0-3), the movement (in grades 0-4) and a grade of extension (distance or prosthetic femoral head and plastic acetabulum in cm at maximal extension after resection of the capsule) have been evaluated. In 191 hip joints not operated before the Trendelenburg sign was negativ before operation in only 31%, after operation it was negativ in 73%. The evaluation of the partial correlation coefficient showed a definite relation between Trendelenburg sign and the grade of extension. The higher the extensibility of the hip joint the more pronounced the Trendelenburg sign. In 71% of 191 cases the movement was increased after total hip replacement. With increased extensibility, the movement becomes better. However it is also related to the movement before operation. The optimal muscular tension and movement of the hip joint can be expected at an extension grade of 1.5-2.0 cm (distance between the prosthetic femoral head and the plastic acetabulum at maximal extension during operation).
全髋关节假体的功能结果在很大程度上受到手术中给予臀中肌的张力影响。低张力可能导致跛行（阳性特伦德伦堡征），高张力可能会减少活动度。在206例全髋关节置换病例中，对特伦德伦堡征（0 - 3级）、活动度（0 - 4级）以及伸展程度（切除关节囊后最大伸展时假体股骨头与塑料髋臼之间的距离，单位为厘米）进行了评估。在191例既往未接受过手术的髋关节中，术前特伦德伦堡征为阴性的仅占31%，术后为阴性的占73%。偏相关系数的评估显示特伦德伦堡征与伸展程度之间存在明确关系。髋关节的伸展性越高，特伦德伦堡征越明显。在191例病例中，71%的患者全髋关节置换术后活动度增加。随着伸展性增加，活动度改善。然而，这也与术前的活动度有关。在伸展程度为1.5 - 2.0厘米（手术中最大伸展时假体股骨头与塑料髋臼之间的距离）时，可预期髋关节具有最佳的肌肉张力和活动度。
