Kolk Sjoerd, Fluit René, Luijten Jim, Heesterbeek Petra J C, Geurts Alexander C H, Verdonschot Nico, Weerdesteyn Vivian
Department of Rehabilitation, Donders Institute for Neuroscience, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Laboratory for Biomechanical Engineering, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
BMC Musculoskelet Disord. 2015 Mar 24;16:68. doi: 10.1186/s12891-015-0524-3.
In adult patients with developmental hip dysplasia, a surgical procedure (triple innominate osteotomy) of the pelvic bone can be performed to rotate the acetabulum in the frontal plane, establishing better acetabular coverage. Although common clinical hip scores demonstrate significant improvements after surgery, they provide only overall information about function. The purpose of this study was to quantify the long-term outcome of triple innominate osteotomy in more detail using gait analyses and muscle strength measurements.
We performed gait analyses at self-selected walking speed as well as isometric hip and knee muscle strength tests in twelve women who had undergone a unilateral triple innominate osteotomy (age: 34 ± 12 y, time post surgery: 80 ± 18 m). We compared the results to reference values obtained from eight healthy peers (age: 33 ± 10 y).
The patients exhibited slight asymmetries in step length (smaller steps) and stance time (longer stance) as well as lower hip abduction moments in the operated limb in early stance compared to the non-operated limb. However, there were no differences in gait compared to healthy controls, even though the patients showed reduced bilateral hip abduction strength compared to controls.
Our results indicate that the patients' gait pattern had generally recovered very well, despite slight asymmetries in spatiotemporal parameters. Subtle deviations in hip abduction moments were observed during gait, whereas hip abduction strength was substantially reduced. Hence, the patients walked at a higher percentage of their maximal capacity. They may, therefore, be prone to fatigue and adopt compensatory gait strategies more quickly than healthy peers when walking long distances.
在成年发育性髋关节发育不良患者中，可对骨盆进行一种手术操作（三联髋臼截骨术），以在额状面旋转髋臼，实现更好的髋臼覆盖。尽管常见的临床髋关节评分显示术后有显著改善，但它们仅提供关于功能的总体信息。本研究的目的是通过步态分析和肌肉力量测量更详细地量化三联髋臼截骨术的长期结果。
我们对12名接受单侧三联髋臼截骨术的女性（年龄：34±12岁，术后时间：80±18个月）进行了自选步行速度下的步态分析以及髋部和膝部等长肌肉力量测试。我们将结果与从8名健康同龄人（年龄：33±10岁）获得的参考值进行了比较。
与未手术侧肢体相比，患者在步长（步幅较小）和站立时间（站立时间较长）上表现出轻微不对称，并且在站立初期患侧肢体的髋外展力矩较低。然而，与健康对照组相比，患者的步态没有差异，尽管患者与对照组相比双侧髋外展力量降低。
我们的结果表明，尽管时空参数存在轻微不对称，但患者的步态模式总体恢复得非常好。在步态中观察到髋外展力矩有细微偏差，而髋外展力量大幅降低。因此，患者以其最大能力的较高百分比行走。因此，他们可能更容易疲劳，并且在长距离行走时比健康同龄人更快地采用代偿性步态策略。
