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前路全髋关节置换术后股外侧皮神经失用症的自然病程

Natural history of lateral femoral cutaneous nerve neuropraxia after anterior approach total hip arthroplasty.

作者信息

Gala Luca, Kim Paul R, Beaulé Paul E

机构信息

Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada.

出版信息

Hip Int. 2019 Mar;29(2):161-165. doi: 10.1177/1120700019827201.

DOI:10.1177/1120700019827201
PMID:30810069
Abstract

AIM

: The aim of this study was to examine the natural history of lateral femoral cutaneous nerve (LFCN) neuropraxia in a previously reported cohort of individuals after direct anterior approach (DAA).

METHODS

: 99 patients (107 hips) with LFCN neuropraxia were identified, out of which 82 patients (87 hips) (83.1%) completed functional outcomes questionnaires at mean follow-up of 5.5 years (4.4-6.9 years). 5 patients were excluded from the study due to intra-articular source of pain and/or revision surgery. The total sample was composed of 77 patients (31 total hip replacements and 51 hip resurfacings) and functional outcomes scores were obtained for all patients.

RESULTS

: At average 5.46-year follow-up, 55 patients (60 hips 73%) still reported symptoms of LFCN neuropraxia but their Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were not inferior to those who had resolution for pain, function and stiffness: p values of 0.716, 0.171, and 0.238, respectively. The mean score on visual analogue scale decreased from 2.32 (SD 2.11) to 1.76 (SD 1.99). 1 patient (1.2%) reported his activities were limited by his symptoms.

CONCLUSION

: Although the majority of patients still report symptoms related to LFCN neuropraxia, symptoms do improve over time and there are no functional limitations. Even if LFCN neuropraxia following DAA does not lead to functional limitations, all patients should be made aware in order to alleviate any long-term functional concerns.

摘要

目的

本研究旨在观察先前报道的采用直接前路(DAA)手术的患者群体中股外侧皮神经(LFCN)神经失用症的自然病史。

方法

确定了99例患有LFCN神经失用症的患者(107髋),其中82例患者(87髋)(83.1%)在平均5.5年(4.4 - 6.9年)的随访中完成了功能结局问卷。5例患者因关节内疼痛来源和/或翻修手术被排除在研究之外。总样本由77例患者(31例全髋关节置换术和51例髋关节表面置换术)组成,并获得了所有患者的功能结局评分。

结果

在平均5.46年的随访中,55例患者(60髋,73%)仍报告有LFCN神经失用症的症状,但其西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分在疼痛、功能和僵硬方面并不低于症状已缓解的患者:p值分别为0.716、0.171和0.238。视觉模拟量表的平均评分从2.32(标准差2.11)降至1.76(标准差1.99)。1例患者(1.2%)报告其活动受到症状限制。

结论

尽管大多数患者仍报告与LFCN神经失用症相关的症状,但症状会随时间改善且不存在功能限制。即使DAA术后的LFCN神经失用症不会导致功能限制,也应告知所有患者以减轻任何长期功能担忧。

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