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全髋关节置换术后步态的时空参数:前路与后路手术入路对比

Spatiotemporal parameters of gait after total hip replacement: anterior versus posterior approach.

作者信息

Maffiuletti Nicola A, Impellizzeri Franco M, Widler Katharina, Bizzini Mario, Kain Michael S H, Munzinger Urs, Leunig Michael

机构信息

Neuromuscular Research Laboratory, Schulthess Clinic, Lengghalde 2-8008 Zurich, Switzerland.

出版信息

Orthop Clin North Am. 2009 Jul;40(3):407-15. doi: 10.1016/j.ocl.2009.02.004.

Abstract

The objective of this preliminary study was to examine possible differences in gait characteristics between subjects operated by way of a direct anterior approach and a posterior approach for primary total-hip arthroplasty, and age-matched healthy controls. Fifty-one subjects walked over an instrumented mat at two different speeds (self-selected comfortable and faster than normal) and spatiotemporal gait parameters were calculated using a validated methodology. Despite excellent clinical and radiographic scores, and irrespective of surgical approach, patients demonstrated an impaired walking performance (lower velocity and shorter step lengths) during fast walking, but not at the self-selected comfortable speed compared with healthy controls. Subjects operated with the posterior approach reported significantly higher stiffness than anterior subjects, but similar pain and function. Six months after total arthroplasty for primary osteoarthritis of the hip, gait characteristics were comparable between subjects having received the direct anterior approach and the posterior approach.

摘要

这项初步研究的目的是检查在初次全髋关节置换术中采用直接前路和后路手术的患者与年龄匹配的健康对照者之间步态特征的可能差异。51名受试者以两种不同速度(自我选择的舒适速度和快于正常的速度)走过一块装有仪器的垫子,并使用经过验证的方法计算时空步态参数。尽管临床和影像学评分优异,且与手术入路无关,但与健康对照者相比,患者在快速行走时表现出步行能力受损(速度较低和步长较短),而在自我选择的舒适速度下则没有。采用后路手术的受试者报告的僵硬程度明显高于前路手术的受试者,但疼痛和功能相似。在因原发性髋骨关节炎进行全关节置换术后6个月,接受直接前路和后路手术的受试者之间的步态特征相当。

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