Yoshii Hiroyuki, Oinuma Kazuhiro, Tamaki Tatsuya, Miura Yoko, Kaneyama Ryutaku, Shiratsuchi Hideaki
Funabashi Orthopedic Hospital, Japan.
Funabashi Orthopedic Hospital, Japan.
J Orthop Sci. 2016 May;21(3):332-5. doi: 10.1016/j.jos.2016.01.008. Epub 2016 Feb 24.
The aim of this study was to compare patients' perception of treatment outcome after unilateral or simultaneous total hip arthroplasty (THA) using the newly developed Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ).
This study included 429 patients treated with primary THA using a direct anterior approach, namely 304 cases of in the unilateral THA (58 males and 246 females; mean age, 62.3 years) and 125 cases of in the simultaneous bilateral THA (24 males and 101 females; mean age, 58.3 years). Items for evaluation included clinical outcomes and all four aspects of the JHEQ score, namely visual analog scale (VAS), pain, movement, and mental status.
The mean operative time per hip was 51.3 ± 19.4 min (range, 22-180 min) in unilateral group and 46.2 ± 15.1 min (range, 26-106 min) in simultaneous bilateral group. The mean operative blood loss per hip was 421.2 ml ± 232.1 ml (range, 70-1300 ml) in unilateral group and 200.8 ± 149.8 ml (range, 30-1040 ml) in simultaneous bilateral group. The total JHEQ score (pain/motion/mental status) improved from 26.5 ± 13.6 (preoperative, 10.1/6.8/9.6) to 69.4 ± 14.8 (1 year postoperatively, 25.1/20.5/23.8) in unilateral group and from 21.0 ± 8.2 (preoperative, 11.9/2.3/6.9) to 74.9 ± 9.5 (1 year postoperatively, 27.2/22.6/25.0) in simultaneous bilateral group. These results demonstrated a significant improvement before and after surgery for patients in both groups. There were not major complications such as dislocation, bone fracture, nerve palsy or symptomatic pulmonary embolism were observed.
In this study, we observed greater improvement in JHEQ in patients treated with bilateral simultaneous THA than in those treated with unilateral THA. These findings demonstrated that bilateral simultaneous THA was related to high patient satisfaction as well as high safety.
本研究旨在使用新开发的日本骨科协会髋关节疾病评估问卷（JHEQ）比较单侧或同期全髋关节置换术（THA）后患者对治疗结果的感知。
本研究纳入了429例行初次THA且采用直接前路入路的患者，其中单侧THA 304例（男性58例，女性246例；平均年龄62.3岁），同期双侧THA 125例（男性24例，女性101例；平均年龄58.3岁）。评估项目包括临床结果和JHEQ评分的所有四个方面，即视觉模拟量表（VAS）、疼痛、活动度和精神状态。
单侧组每侧髋关节的平均手术时间为51.3±19.4分钟（范围22 - 180分钟），同期双侧组为46.2±15.1分钟（范围26 - 106分钟）。单侧组每侧髋关节的平均术中失血量为421.2毫升±232.1毫升（范围70 - 1300毫升），同期双侧组为200.8±149.8毫升（范围30 - 1040毫升）。单侧组JHEQ总分（疼痛/活动度/精神状态）从术前的26.5±13.6（10.1/6.8/9.6）提高到术后1年的69.4±14.8（25.1/20.5/23.8），同期双侧组从术前的21.0±8.2（11.9/2.3/6.9）提高到术后1年的74.9±9.5（27.2/22.6/25.0）。这些结果表明两组患者术后均有显著改善。未观察到脱位、骨折、神经麻痹或有症状的肺栓塞等主要并发症。
在本研究中，我们观察到同期双侧THA治疗的患者JHEQ改善程度大于单侧THA治疗的患者。这些发现表明同期双侧THA与高患者满意度以及高安全性相关。
