Bülbül Murat, Ayanoğlu Semih, Beytemür Ozan, Gürkan Volkan, Esenyel Cem Zeki, Gürbüz Hakan
Department of Orthopedics and Traumatology, Vakif Gureba Training and Research Hospital, Fatih, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2010;44(2):124-6. doi: 10.3944/AOTT.2010.2290.
We evaluated the relationship between morphometric parameters such as height, weight, and body mass index with the development of the Trendelenburg gait following the Hardinge approach, which is one of the most commonly used approaches in total hip arthroplasty.
The study included 59 patients (43 women, 16 men; mean age 55 years; range 37 to 74 years) who underwent total hip arthroplasty via the Hardinge approach for primary coxarthrosis. The patients were examined postoperatively at 15 days, and at the end of the first and third months. The mean follow-up period was 24.3 months (range 12 to 37 months). The height, weight, and body mass index values of the patients with and without a positive Trendelenburg sign were compared.
The Trendelenburg sign was positive in 19 patients (32.2%) following total hip arthroplasty with the Hardinge approach and persisted for a mean of 8.3 months (range 4-14 months). Patients with a positive Trendelenburg sign had a mean height of 157.4 cm (range 151 to 173 cm), mean weight of 82.5 kg (range 70 to 108 kg), and mean body mass index of 33.2 kg/m(2) (range 25.4 to 30.5 kg/m(2)). The corresponding figures in patients without a Trendelenburg sign were as follows: 166.3 cm (range 158 to 180 cm), 79.4 kg (range 72 to 94 kg), and 28.7 kg/m(2) (range 21.6 to 30.5 kg/m(2)). There was no significant difference between the two patient groups with respect to weight, but height and body mass index showed highly significant differences (p<0.0001).
Based on our finding that patients having a significantly shorter height and greater body mass index sustained Trendelenburg positivity for quite a long time, we recommend that these two factors be taken into consideration in the preoperative evaluation of patients for total hip arthroplasty with the Hardinge approach. Thus, the use of the Hardinge approach in total hip arthroplasty may not be convenient in short subjects having borderline obesity.
我们评估了身高、体重和体重指数等形态学参数与采用哈丁格入路（全髋关节置换术中最常用的入路之一）后特伦德伦伯格步态发展之间的关系。
该研究纳入了59例患者（43例女性，16例男性；平均年龄55岁；范围37至74岁），这些患者因原发性髋关节骨关节炎通过哈丁格入路接受了全髋关节置换术。患者在术后15天、第一个月末和第三个月末接受检查。平均随访期为24.3个月（范围12至37个月）。比较了有和没有特伦德伦伯格征阳性的患者的身高、体重和体重指数值。
采用哈丁格入路进行全髋关节置换术后，19例患者（32.2%）出现特伦德伦伯格征阳性，且平均持续8.3个月（范围4至14个月）。特伦德伦伯格征阳性的患者平均身高为157.4厘米（范围151至173厘米），平均体重为82.5千克（范围70至108千克），平均体重指数为33.2千克/平方米（范围25.4至30.5千克/平方米）。没有特伦德伦伯格征的患者的相应数据如下：166.3厘米（范围158至180厘米），79.4千克（范围72至94千克），28.7千克/平方米（范围21.6至30.5千克/平方米）。两组患者在体重方面无显著差异，但身高和体重指数显示出高度显著差异（p<0.0001）。
基于我们的发现，即身高明显较短且体重指数较高的患者特伦德伦伯格征阳性持续时间较长，我们建议在对采用哈丁格入路进行全髋关节置换术的患者进行术前评估时考虑这两个因素。因此，对于身高较矮且接近肥胖的患者，在全髋关节置换术中使用哈丁格入路可能不太适宜。
