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根据术前活动水平与标准全髋关节置换术相匹配的表面置换术——术后结果比较

Resurfacing matched to standard total hip arthroplasty by preoperative activity levels - a comparison of postoperative outcomes.

作者信息

Zywiel Michael G, Marker David R, McGrath Mike S, Delanois Ronald E, Mont Michael A

机构信息

RubinInstitute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.

出版信息

Bull NYU Hosp Jt Dis. 2009;67(2):116-9.

Abstract

BACKGROUND

Some studies have suggested that resurfacing patients are generally more active postoperatively than their conventional total hip arthroplasty (THA)counterparts, but controversy remains over whether this is a reflection of preferential use of resurfacing for younger and higher-activity patients. We hypothesized that, when controlling for preoperative activity levels, in addition to relevant clinical and demographic factors, resurfacing provides similar results to conventional hip arthroplasty.

MATERIALS AND METHODS

The specific question asked was whether resurfacing patients had differences in postoperative activity level, clinical outcomes, or rate of revisions, as compared to a matched cohort of patients treated with conventional THA. Thirty-three patients (23 men and 10 women) who were treated with resurfacing arthroplasties were matched to a cohort of patients who underwent conventional hip arthroplasty by gender, age, body mass index (BMI), and preoperative activity level. Mean preoperative Harris hip scores and length of follow-up were similar for the two groups. Postoperative weighted activity scores, Harris hip scores, patient satisfaction score, pain scores, and revision rates were evaluated at a mean final follow-up of 42 months (range, 25 to 68 months) for the resurfacing group and 45 months (range, 24 to 67 months) for the conventional hip group, and analyzed for differences.

RESULTS

At final follow-up, activity levels were significantly higher in the resurfacing group, with a mean weighted activity score of 10.0 points (range, 1.0 to 27.5 points), as compared to a mean score of 5.3 points (range, 0 to 12.0 points) in the THA group. Mean Harris hip scores, patients satisfaction scores, and pain scores were similar for both groups. There were no revisions in either group.

CONCLUSIONS

The results of this study suggest that patients treated with hip resurfacing arthroplasty have a significantly higher postoperative activity level, as compared to those treated with conventional THA, when controlled for preoperative factors.

摘要

背景

一些研究表明,与接受传统全髋关节置换术(THA)的患者相比,接受表面置换术的患者术后通常活动更为积极,但对于这是否反映了表面置换术更倾向于应用于年轻且活动量较大的患者,仍存在争议。我们假设,在控制术前活动水平以及相关临床和人口统计学因素的情况下,表面置换术与传统髋关节置换术的效果相似。

材料与方法

具体问题是,与接受传统THA治疗的匹配队列患者相比,接受表面置换术的患者在术后活动水平、临床结果或翻修率方面是否存在差异。33例接受表面置换术的患者(23例男性和10例女性)与一组接受传统髋关节置换术的患者在性别、年龄、体重指数(BMI)和术前活动水平方面进行匹配。两组患者术前Harris髋关节评分均值和随访时间相似。在表面置换术组平均最终随访42个月(范围25至68个月)、传统髋关节置换术组平均最终随访45个月(范围24至67个月)时,评估术后加权活动评分、Harris髋关节评分、患者满意度评分、疼痛评分和翻修率,并分析差异。

结果

在最终随访时,表面置换术组的活动水平显著更高,平均加权活动评分为10.0分(范围1.0至27.5分),而THA组的平均评分为5.3分(范围0至12.0分)。两组的平均Harris髋关节评分、患者满意度评分和疼痛评分相似。两组均无翻修病例。

结论

本研究结果表明,在控制术前因素的情况下,与接受传统THA治疗的患者相比,接受髋关节表面置换术治疗的患者术后活动水平显著更高。

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