Zeni Joseph, Madara Kathleen, Rubano James
Del Med J. 2016 Nov;88(11):334-340.
Although total hip arthroplasty (THA) has become standard procedure to manag the symptoms of end-stage osteoarthritis (OA), there are multiple surgical approaches to acceE the hip joint. To date, there is limited information on the effect of surgical approach on muscle strength and performance-based measures of functional ability after THA.
QUESTIONS/PURPOSES: The purpose of this study was to compare the effect of posterior or anterolateral surgical approaches on strength and function after THA. We hypothesized that individuals who underwent a posterior approach would have greater strength and performance-based measures of function than individuals who underwent an anterolateral approach one year after surgery. We also hypothesized that there would be no difference in pain or self-reported outcomes at follow-up.
63 subjects were tested two to four weeks prior to THA and then three months and 12 months after THA. Subjects were divided into a posterior approach and lateral approac groups. Patients completed functional testing, strength measures, as well as self-reported questionnaires at each time point. Repeated-measures analysis of variance (ANOVA) tests were performed to test the change between the pre-operative and one year time point. Descriptive data were reported for all three time points.
There was a significant interaction effect for hip abduction strength (p=0.025) and the lateral group was significantly weaker at one year (p=0.018). No other variable demonstrated a significant interaction effect; however, all other variables with the exception of hip abductor strength (p=0.883) and pain on the non-operated side (p=0.527) demonstrated a significant main effect of time (p≤0.01) in which there was significant improvement at 1 year.
The lateral surgical approaches result in weaker hip abduction one year after THA; however significant and clinically meaningful improvements in functional ability were seen for most subiects. regardless of surgical approach.
尽管全髋关节置换术（THA）已成为治疗终末期骨关节炎（OA）症状的标准手术，但进入髋关节有多种手术入路。迄今为止，关于手术入路对THA术后肌肉力量和基于功能能力的测量指标的影响的信息有限。
问题/目的：本研究的目的是比较后外侧或前外侧手术入路对THA术后力量和功能的影响。我们假设接受后外侧入路的个体在术后一年比接受前外侧入路的个体具有更强的力量和基于功能的测量指标。我们还假设随访时疼痛或自我报告的结果没有差异。
63名受试者在THA术前两到四周进行测试，然后在THA术后三个月和12个月进行测试。受试者分为后外侧入路组和外侧入路组。患者在每个时间点完成功能测试、力量测量以及自我报告问卷。进行重复测量方差分析（ANOVA）测试以检验术前和一年时间点之间的变化。报告所有三个时间点的描述性数据。
髋关节外展力量存在显著的交互作用（p = 0.025），外侧入路组在一年时明显较弱（p =
