Vreden Russian Research Institute of Traumatology and Orthopedics, 8, ul. Akad. Baykova, St. Petersburg, Russian Federation, 195427.
Hip Pathology Department, Vreden Russian Research Institute of Traumatology and Orthopedics, 8, ul. Akad. Baykova, St. Petersburg, Russian Federation, 195427.
Int Orthop. 2019 Nov;43(11):2485-2490. doi: 10.1007/s00264-019-04395-x. Epub 2019 Aug 28.
The purpose of this research was to evaluate the effectiveness of hip joint arthroplasty in patients with different correction of the length of the legs and identifying factors that influence the outcome.
We analyzed 93 patients operated upon with an initial shortening of the limb length by more than 3 cm. The difference in the length of the limbs ranged from 3 to 12 cm, which averaged 5 cm. Immediately after surgery and after three to 12 months, a control examination was performed with measurement of the length of the lower extremities and the function of the joint, using the Harris scale.
The study revealed three versions of the result of the correction of the length of the limb after hip joint arthroplasty: saving limb shortening (n = 16 (17%) with HHS 80 (95% CI, 78.4 to 83.4%); full restoration of limb length (n = 70 (75,5%) with HHS 78 (95% CI, 74.6 to 80.2%); excess limb lengthening (n = 7 (7.5%) with HHS 68 (95% CI, 63.5 to 73.5%).
So that, incorrect lengthening of the lower limb during arthroplasty leads to lameness, discomfort, muscle tension, which ultimately leads to pain. Optimal result of hip arthroplasty and ensure the necessary amplitude of movements, it is advisable to use prediction criteria of the leveling of the limb length, which are: the duration of the disease, presence of consequences of previous operations, gender, age, degree of tissue rigidity, severity of hip-spine syndrome, and scoliotic deformity.
本研究旨在评估髋关节置换术对不同下肢长度矫正患者的疗效，并确定影响疗效的因素。
我们分析了 93 例肢体初始缩短超过 3cm 的患者。肢体长度差异为 3 至 12cm，平均为 5cm。术后即刻及术后 3 至 12 个月，采用 Harris 评分对下肢长度和关节功能进行对照检查。
研究发现髋关节置换术后肢体长度矫正的结果有三种类型：保存肢体缩短（n=16（17%），HHS 为 80（95%CI，78.4 至 83.4%）；完全恢复肢体长度（n=70（75.5%），HHS 为 78（95%CI，74.6 至 80.2%）；肢体过度延长（n=7（7.5%），HHS 为 68（95%CI，63.5 至 73.5%）。
因此，关节置换术中下肢的不正确延长会导致跛行、不适和肌肉紧张，最终导致疼痛。为了获得髋关节置换术的最佳效果并确保必要的运动幅度，建议使用肢体长度平衡的预测标准，包括：疾病持续时间、既往手术后果、性别、年龄、组织僵硬程度、髋关节脊柱综合征严重程度和脊柱侧凸畸形。
