Recnik G, Kralj-Iglic V, Iglic A, Antolic V, Kramberger S, Vengust R
Department of Orthopedic Surgery, University Clinical Hospital Maribor, Ljubljanska 5, SI-2000 Maribor, Slovenia.
Clin Biomech (Bristol). 2007 Dec;22(10):1119-24. doi: 10.1016/j.clinbiomech.2007.08.002. Epub 2007 Sep 14.
Biomechanical parameters of the hip have been suggested to have an important influence on the development of osteoarthritis. We aimed to find out whether higher stress is generated in a hip that subsequently results in earlier hip arthroplasty compared to the contralateral hip in the same subject.
Standard anterior-posterior pelvic radiographs with no or subtle radiological signs of hip osteoarthritis, of 59 female patients, who underwent hip arthroplasty for primary osteoarthritis years later, were selected from the archives. For each subject peak contact hip stress of the hip with earlier arthroplasty and of the contralateral hip (pair of hips), was calculated from the radiographically obtained geometrical parameters with the HIPSTRESS program, which is based on a three-dimensional biomechanical model of the resultant hip force in the one-legged stance and a three-dimensional mathematical model of the contact hip stress distribution. Differences in peak contact hip stress within pairs of hips were determined for subjects with unilateral (22 pairs of hips) and bilateral disease (37 pairs of hips) by using paired-samples T-test.
In the population of subjects with unilateral osteoarthritis, average peak contact hip stress was significantly higher (P = 0.007) in hips with arthroplasty (2.44 kPa/N) than in contralateral hips (2.32 kPa/N). In the population of subjects with bilateral osteoarthritis, average peak contact hip stress was significantly higher (P<0.001) in hips with earlier arthroplasty (2.54 kPa/N) than in contralateral hips (2.35 kPa/N).
Results are consistent with the hypothesis that higher peak contact hip stress results in earlier hip arthroplasty due to faster development of idiopathic osteoarthritis.
有研究表明，髋关节的生物力学参数对骨关节炎的发展具有重要影响。我们旨在探究，与同一受试者的对侧髋关节相比，随后接受髋关节置换术的髋关节是否会产生更高的应力，从而导致更早进行髋关节置换。
从档案中选取59例女性患者的标准骨盆前后位X线片，这些患者数年后因原发性骨关节炎接受了髋关节置换术，其髋关节无或仅有轻微的骨关节炎放射学迹象。对于每个受试者，使用HIPSTRESS程序，根据X线片获得的几何参数，计算较早接受置换的髋关节和对侧髋关节（一对髋关节）的峰值接触髋部应力，该程序基于单腿站立时髋关节合力的三维生物力学模型和接触髋部应力分布的三维数学模型。通过配对样本T检验，确定单侧疾病（22对髋关节）和双侧疾病（37对髋关节）患者髋关节对之间的峰值接触髋部应力差异。
在单侧骨关节炎患者群体中，接受置换的髋关节的平均峰值接触髋部应力（2.44 kPa/N）显著高于对侧髋关节（2.32 kPa/N）（P = 0.007）。在双侧骨关节炎患者群体中，较早接受置换的髋关节的平均峰值接触髋部应力（2.54 kPa/N）显著高于对侧髋关节（2.35 kPa/N）（P<0.001）。
结果与以下假设一致，即较高的峰值接触髋部应力会导致特发性骨关节炎发展更快，从而更早进行髋关节置换。
