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前外侧微创全髋关节置换术后髋外展肌的力量与功能

The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty.

作者信息

Tan Jixiang, Chen Hong, Chen Cheng, Liang Xi, Huang Wei

机构信息

Department of Emergency and Critical Care Medicine, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.

出版信息

Chin J Traumatol. 2014 Apr 1;17(2):73-8.

Abstract

OBJECTIVE

To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA) patients undergoing anterolateral minimally invasive (ALMI) approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF) patients than in non-femoral neck fracture (nFNF) patients.

METHODS

A total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg's sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities (WOMAC) score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P<0.05.

RESULTS

The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear.

CONCLUSION

This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA.

摘要

目的

分析接受前外侧微创入路初次全髋关节置换术(THA)患者术后髋外展肌功能不全的程度,并探讨股骨颈骨折(FNF)患者的临床结局是否比非股骨颈骨折(nFNF)患者更有利。

方法

本研究共纳入48例患者。每位患者在术前以及术后6周、12周、24周和48周接受临床检查。记录外展肌扭矩、单足站立试验、步态速度、Harris髋关节评分、牛津髋关节评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及视觉模拟量表疼痛评分。使用SPSS 18.0软件进行统计评估。显著性水平设定为P<0.05。

结果

从术后6周直到最后一次随访,手术侧髋关节的外展肌扭矩和恢复率呈逐渐改善趋势。术后直至术后24周,步态速度、Harris髋关节评分、牛津髋关节评分和WOMAC评分显著改善。在FNF组中,术后6周时手术侧的外展肌扭矩和恢复率显著高于nFNF组,然而,随着时间推移,这种趋势趋于消失。

结论

本研究表明,患者在术后早期可获得良好的外展肌力量和功能,并且髋骨关节炎、类风湿关节炎、股骨头缺血性坏死患者在接受前外侧微创全髋关节置换术后髋外展肌功能可得到显著改善。

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