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全髋关节置换术治疗发育性髋关节发育不良患者的步态运动学偏差

Gait Kinematic Deviations in Patients With Developmental Dysplasia of the Hip Treated With Total Hip Arthroplasty.

作者信息

Nie Yong, Ning Ning, Pei Fuxing, Shen Bin, Zhou Zongke, Li Zongming

出版信息

Orthopedics. 2017 May 1;40(3):e425-e431. doi: 10.3928/01477447-20170109-04. Epub 2017 Jan 11.

DOI:10.3928/01477447-20170109-04
PMID:28075436
Abstract

Comprehensive gait analysis of patients with Crowe type II and III developmental dysplasia of the hip (DDH) after successful total hip arthroplasty (THA) is lacking in the literature. This study evaluated gait function in joint kinematics after unilateral and bilateral THA in patients with DDH. In addition, the effect of high cup position on gait function was investigated. A total of 16 unilateral and 15 bilateral cementless THA patients due to DDH and 10 healthy participants comprised the study population. Levels of superior displacement of the acetabular cup and leg-length discrepancy after THA were measured. Three-dimensional gait analysis for patients who underwent THA was performed at least 1 year postoperatively. Range of motion (ROM), particularly sagittal (flexion/extension) and frontal (adduction/abduction) hip joint ROM, was significantly lower in both the unilateral and bilateral groups than in healthy participants. Sagittal (flexion/extension) hip ROM in patients with DDH was greater in the unilateral group than in the bilateral group. A significant influence of high acetabular cup position on hip joint kinematics was not observed in the unilateral subgroups (mean level of cup superior displacement was 11.8 mm). In contrast, a significant influence of high acetabular cup position on hip joint kinematics was observed in the bilateral subgroups (mean level of cup superior displacement was 21.3 mm). The functional symmetry and cup superior displacement within 12 mm in patients with DDH after unilateral THA contributed to the restoration of normal hip biomechanics. [Orthopedics. 2017; 40(3):e425-e431.].

摘要

文献中缺乏对Crowe II型和III型发育性髋关节发育不良(DDH)患者成功进行全髋关节置换术(THA)后的全面步态分析。本研究评估了DDH患者单侧和双侧THA后关节运动学中的步态功能。此外,还研究了髋臼高位对步态功能的影响。共有16名单侧和15名双侧因DDH接受非骨水泥型THA的患者以及10名健康参与者组成了研究人群。测量了THA后髋臼杯的上移水平和腿长差异。对接受THA的患者在术后至少1年进行三维步态分析。单侧和双侧组的运动范围(ROM),特别是矢状面(屈伸)和额状面(内收外展)髋关节ROM,均显著低于健康参与者。DDH患者的矢状面(屈伸)髋关节ROM在单侧组中大于双侧组。在单侧亚组中未观察到髋臼杯高位对髋关节运动学有显著影响(髋臼杯上移平均水平为11.8 mm)。相比之下,在双侧亚组中观察到髋臼杯高位对髋关节运动学有显著影响(髋臼杯上移平均水平为21.3 mm)。DDH患者单侧THA后功能对称性和髋臼杯上移在12 mm以内有助于恢复正常的髋关节生物力学。[《骨科》。2017;40(3):e425 - e431。]

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