Chinzei Nobuaki, Noda Mitsuaki, Matsushita Takehiko, Inui Atsuyuki, Osawa Shin, Okimura Kenjiro, Takahashi Masayasu, Saegusa Yasuhiro
Department of Orthopaedic Surgery, Konan Hospital, Kobe, 658-0064, Japan.
Department of Orthopaedic Surgery, Nishi Hospital, Kobe, 657-0037, Japan.
Eur J Orthop Surg Traumatol. 2020 Feb;30(2):251-256. doi: 10.1007/s00590-019-02545-w. Epub 2019 Sep 6.
The primary purpose of this study was to compare the postoperative muscular strength and functional performance between early versus late bipolar hip arthroplasty (BHA) intervention for femoral neck fracture classified by the duration from the onset to surgery.
Twenty-one patients who could walk at 12 months or more after BHA were enrolled into this study. We examined the muscular strength of hip flexion, extension, abduction, and knee extension of these patients. Time of one-leg standing, timed up and go test, pain grade by visual analog scale, and Barthel index were also evaluated as functional indices. We classified these patients into two groups by the duration from the onset to surgery, namely: within 3 days until BHA (early OP) and more than 4 days (late OP) to compare these indices at the latest follow-up.
The mean days until operation were 2.3 days in the early-OP group and 5.9 days in the late-OP group, showing a significant difference between the two groups. Muscular strength and other functional indices were also found to have no significant differences between these two groups.
Our study suggests that the delay to operate might not severely compromise the muscular strength around the hip joint for least 1.5 years among ambulatory patients.
本研究的主要目的是比较早期与晚期双极髋关节置换术（BHA）对股骨颈骨折的术后肌肉力量和功能表现，根据从发病到手术的持续时间进行分类。
21例在BHA术后12个月或更长时间能够行走的患者纳入本研究。我们检查了这些患者的髋关节屈曲、伸展、外展和膝关节伸展的肌肉力量。单腿站立时间、计时起立行走测试、视觉模拟量表疼痛分级和Barthel指数也作为功能指标进行评估。我们根据从发病到手术的持续时间将这些患者分为两组，即：BHA手术前3天内（早期手术组）和超过4天（晚期手术组），以比较最新随访时的这些指标。
早期手术组的平均手术天数为2.3天，晚期手术组为5.9天，两组间差异显著。这两组之间的肌肉力量和其他功能指标也没有显著差异。
我们的研究表明，在能行走的患者中，手术延迟至少1.5年可能不会严重损害髋关节周围的肌肉力量。
