Plaass Christian, Clauss Martin, Ochsner Peter E, Ilchmann Thomas
Department for Orthopaedic Surgery, Kantonsspital Liestal, Liestal, Switzerland.
Hip Int. 2011 Jul-Aug;21(4):441-9. doi: 10.5301/HIP.2011.8575.
The effect of leg length differences on early clinical outcome after total hip arthroplasty remains uncertain. We performed a prospective study on 94 patients who were evaluated preoperatively and one year after surgery for clinical leg length differences, which were then compared with radiological measurements. The effect of leg length differences on walking ability, limp, pain and patient satisfaction was studied. The mean clinical leg length difference after operation was 0.05 cm (-1.5 to 1.5, SD 0.5). Clinical and radiological measurements correlated poorly (ω =0.36 pre- and ω =0.186 postoperatively). Patients with a shorter operated leg on clinical assessment were more prone to limping (p<0.05), and patients with a longer leg had more pain compared to patients with equal leg lengths (p<0.05). Walking ability, Harris Hip Score and patient satisfaction were only marginally affected by leg length differences. Virtually equal leg length was achieved for most patients but small differences had a negative influence in relation to limping and pain. Patients should be counselled pre-operatively about possible leg length differences and associated symptoms.
全髋关节置换术后下肢长度差异对早期临床结果的影响仍不确定。我们对94例患者进行了一项前瞻性研究，在术前和术后一年对其临床下肢长度差异进行评估，然后与影像学测量结果进行比较。研究了下肢长度差异对行走能力、跛行、疼痛和患者满意度的影响。术后平均临床下肢长度差异为0.05厘米（-1.5至1.5，标准差0.5）。临床测量与影像学测量的相关性较差（术前ω=0.36，术后ω=0.186）。临床评估中患侧下肢较短的患者更容易跛行（p<0.05），与双下肢等长的患者相比，患侧下肢较长的患者疼痛更明显（p<0.05）。行走能力、Harris髋关节评分和患者满意度仅受到下肢长度差异的轻微影响。大多数患者实现了双下肢几乎等长，但微小差异对跛行和疼痛有负面影响。术前应向患者告知可能存在的下肢长度差异及相关症状。
