[全髋关节置换术后股骨偏心距改变对疼痛和功能的影响]

[Effect of femoral offset change on pain and function after total hip arthroplasty].

作者信息

Xu Boyong, Yang Desheng, Aili Rehei, Cao Li

机构信息

Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P.R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Jul;27(7):843-6.

PMID:24063174

Abstract

OBJECTIVE

To investigate the effects of altering the femoral offset after total hip arthroplasty on postoperative pain and function.

METHODS

A total of 162 patients undergoing single total hip arthroplasty between March 2009 and December 2011 met the inclusion criteria. According to difference of femoral offset between operative side and contralateral side, the patients were divided into 3 groups: decreased offset group (< 5 mm, 30 cases), normal offset group (-5-5 mm, 87 cases), and increased offset group (> 5 mm, 45 cases). There was no significant difference in gender, age, and disease duration among 3 groups (P > 0.05). The types of femoral stem and head prosthesis were compared among 3 groups. Short Form 12 Health Survey (SF-12) score, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, and Harris score were used to evaluate the clinical outcomes.

RESULTS

Standard offset femoral prosthesis was most used, followed by increased offset femoral prosthesis, and decreased offset femoral prosthesis was least in 3 groups. The types of femoral stem and head prosthesis showed no significant difference among 3 groups (P > 0.05). The patients were followed up 12-33 months (mean, 25 months). There was no significant difference in SF-12 score among 3 groups at 1 year after operation (P > 0.05); there was no significant difference in WOMAC pain and stiffness scores among 3 groups (P > 0.05) except WOMAC body function score (P < 0.05). According to Harris scoring criteria, the results were excellent in 13 cases, good in 8 cases, fair in 7 cases, and poor in 2 cases in decreased offset group; the results were excellent in 42 cases, good in 34 cases, fair in 9 cases, and poor in 2 cases in normal offset group; the results were excellent in 31 cases, good in 12 cases, and fair in 2 cases in increased offset group; and significant difference was found among 3 groups (Z= -3.152, P=0.008).

CONCLUSION

Increased offset is more conducive to joint functional recovery and pain relief; decreased offset may lead to joint function deterioration and pain aggravation.

摘要

目的

探讨全髋关节置换术后改变股骨偏心距对术后疼痛及功能的影响。

方法

2009年3月至2011年12月期间，共有162例行单全髋关节置换术的患者符合纳入标准。根据手术侧与对侧股骨偏心距的差异，将患者分为3组：偏心距减小组（<5 mm，30例）、正常偏心距组（-5～5 mm，87例）和偏心距增加组（>5 mm，45例）。3组患者在性别、年龄和病程方面差异无统计学意义（P>0.05）。比较3组患者股骨柄和股骨头假体的类型。采用简明健康调查量表（SF-12）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分及Harris评分评估临床疗效。

结果

3组中标准偏心距股骨假体使用最多，其次是偏心距增加的股骨假体，偏心距减小的股骨假体使用最少。3组患者股骨柄和股骨头假体的类型差异无统计学意义（P>0.05）。患者随访12～33个月（平均25个月）。术后1年3组患者SF-12评分差异无统计学意义（P>0.05）；除WOMAC身体功能评分外（P<0.05），3组患者WOMAC疼痛和僵硬评分差异无统计学意义（P>0.05）。根据Harris评分标准，偏心距减小组优13例，良8例，可7例，差2例；正常偏心距组优42例，良34例，可9例，差2例；偏心距增加组优31例，良12例，可2例；3组间差异有统计学意义（Z=-3.152，P=0.008）。