Girard J, Lons A, Pommepuy T, Isida R, Benad K, Putman S
Université de Lille Nord de France, 59000 Lille, France; Département de médecine du sport, faculté de médecine de Lille, université de Lille 2, 59000 Lille, France; Service d'orthopédie C, hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France.
Université de Lille Nord de France, 59000 Lille, France; Service d'orthopédie C, hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France.
Orthop Traumatol Surg Res. 2017 Sep;103(5):675-678. doi: 10.1016/j.otsr.2017.04.004. Epub 2017 May 25.
Returning to high-impact sport is an increasingly frequent functional demand following hip replacement. The literature, however, is sparse on the subject and nonexistent regarding triathlon. We therefore conducted a retrospective study of hip resurfacing in triathlon players, to determine: (1) whether it is possible to return to this kind of sport; (2) if so, whether it is possible to return to the same level; and (3) how a resurfaced hip behaves under these conditions.
Hip resurfacing allows return to competition level in long-distance triathlon.
A single-center single-operator retrospective study included patients undergoing hip resurfacing with the Conserve Plus implant inserted through a posterolateral approach, who had ceased long-distance triathlon practice due to osteoarthritis of the hip. Fifty-one of the 1688 patients undergoing resurfacing during the inclusion period were long-distance triathlon players.
The series comprised 48 patients: 51 implants; 43 male, 5 female; mean age, 44.8 years (range, 28.2-58.9 years). At a mean 4.7 years' follow-up (range, 2.2-7.6 years), all clinical scores showed significant improvement; Merle d'Aubigné and Harris scores rose respectively from 12.3 (5-16) and 42 (37-56) preoperatively to 17.5 (13-18) and 93.2 (73-100) (P<0.001). There were no cases of dislocation or implant revision. Forty-five patients returned to sport (94%). Rates of return to swimming, cycling and running were respectively 38/48 (79%), 41/48 (85%) and 33/48 (69%). Preoperatively, all patients had taken part in at least 1 competition: 29 with distance=70.3km and 19 with distance=140.6km. At follow-up, 28 patients had taken part in an Ironman competition: 21 with distance=70.3km and 7 with distance=140.6km. Mean competition performance did not differ between pre and postoperative periods.
Return-to-sport rates were good following hip resurfacing. Non-impact sports (swimming, cycling) predominated postoperatively, whereas the rate of impact sport (running) diminished. Return to competition-level sport (extreme triathlon) was possible for 28/48 patients (58%). Implant survival seemed unaffected by this high-impact sports activity at a mean 4.7 years' follow-up.
IV, retrospective, non-controlled.
髋关节置换术后恢复高强度运动的功能需求日益常见。然而，关于这一主题的文献稀少，而关于铁人三项运动的文献则不存在。因此，我们对铁人三项运动员的髋关节表面置换进行了一项回顾性研究，以确定：（1）是否有可能恢复这项运动；（2）如果可以，是否有可能恢复到相同水平；（3）在这些条件下，表面置换后的髋关节表现如何。
髋关节表面置换可使患者恢复长距离铁人三项的比赛水平。
一项单中心单术者的回顾性研究纳入了因髋关节骨关节炎而停止长距离铁人三项运动的患者，这些患者通过后外侧入路植入Conserve Plus假体进行髋关节表面置换。在纳入期间接受表面置换的1688例患者中，有51例是长距离铁人三项运动员。
该系列包括48例患者：51个假体；男性43例，女性5例；平均年龄44.8岁（范围28.2 - 58.9岁）。平均随访4.7年（范围2.2 - 7.6年），所有临床评分均显著改善；Merle d'Aubigné评分和Harris评分分别从术前的12.3（5 - 16）和42（37 - 56）提高到17.5（13 - 18）和93.2（73 - 100）（P<0.001）。没有脱位或假体翻修的病例。45例患者恢复运动（94%）。游泳、骑自行车和跑步的恢复率分别为38/48（79%）、41/48（85%）和33/48（69%）。术前，所有患者至少参加过1次比赛：29例参加70.3公里比赛，19例参加140.6公里比赛。随访时，28例患者参加了铁人三项比赛：21例参加70.3公里比赛，7例参加140.6公里比赛。术前和术后的平均比赛成绩没有差异。
髋关节表面置换后的运动恢复率良好。术后非冲击性运动（游泳、骑自行车）占主导，而冲击性运动（跑步）的恢复率降低。48例患者中有28例（58%）能够恢复到比赛水平的运动（极限铁人三项）。在平均4.7年的随访中，假体生存率似乎不受这种高强度运动的影响。
IV级，回顾性、非对照研究。
