Leuchte S, Luchs A, Wohlrab D
Institut für Sportwissenschaft, Martin-Luther-Universität Halle-Wittenberg, Germany.
Z Orthop Ihre Grenzgeb. 2007 Jan-Feb;145(1):74-80. doi: 10.1055/s-2007-960511.
Benefits of less damage of soft tissues and muscles in minimally invasive hip replacement lead to expectations of better results in gait rehabilitation. The aim of the study is to evaluate post-operative walking ability in terms of different surgical approaches.
16 patients underwent a minimally invasive total hip replacement (MIS group) and 16 other patients got a THA using a transgluteal approach (standard group). Differences in functional indices of ground reaction forces and symmetry indices were measured one day pre-operatively as well as 8, 14 and 28 weeks post-operatively. The results were compared between the surgical approaches and to an age-matched healthy control group.
There are significantly reduced pain symptoms and a higher functional ability in both surgical groups 8 weeks post-operatively. There are no differences in gait parameters between the surgical groups after 28 weeks. Trends in gait velocity, temporal parameters and in functional indices of ground reaction forces show advantages for the minimally invasive group 8 and 14 weeks post-operatively. Patients do not reach the age-matched control group.
Obviously the immediate post-operative advantages of minimally invasive hip replacement provide better chances for gait rehabilitation compared to the transgluteal approach. Due to the complexity of the problem clinical and gait analysis studies should be linked more closely.
微创髋关节置换术中软组织和肌肉损伤较小的益处引发了对步态康复能取得更好效果的期望。本研究的目的是根据不同手术入路评估术后行走能力。
16例患者接受了微创全髋关节置换术（微创组），另外16例患者采用经臀入路进行全髋关节置换术（标准组）。在术前1天以及术后8周、14周和28周测量地面反作用力功能指标和对称性指标的差异。将手术入路之间的结果与年龄匹配的健康对照组进行比较。
术后8周，两个手术组的疼痛症状均显著减轻，功能能力更高。28周后，手术组之间的步态参数没有差异。术后8周和14周，微创组在步态速度、时间参数和地面反作用力功能指标方面呈现优势。患者未达到年龄匹配的对照组水平。
显然，与经臀入路相比，微创髋关节置换术的术后即时优势为步态康复提供了更好的机会。由于问题的复杂性，临床和步态分析研究应更紧密地联系起来。
