Donner Stefanie, Rehbein Philipp, Schneider Michael, Pfeil Joachim, Drees Philipp, Kutzner Karl Philipp
Department of Orthopaedic Surgery and Traumatology, St Josefs Hospital Wiesbaden, Wiesbaden, Germany.
Department of Orthopaedics and Traumatology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Orthop J Sports Med. 2019 Sep 27;7(9):2325967119872746. doi: 10.1177/2325967119872746. eCollection 2019 Sep.
Single-stage bilateral total hip arthroplasty (THA) is an alternative to staged unilateral THA in patients suffering from bilateral hip arthritis; however, there is still broad concern regarding the safety and reliability of this procedure. Short-stem THA has emerged in recent years. To date, no data are available on sports and recreational activity levels after single-stage bilateral short-stem THA in the general patient population.
Patients who have undergone single-stage bilateral short-stem THA return to a satisfying level of sports and recreational activity at midterm follow-up.
Case series; Level of evidence, 4.
A total of 54 consecutive patients (108 hips) were prospectively included. Midterm follow-up was performed in 51 patients (94.4%). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and the Harris Hip Score (HHS) were assessed clinically after a mean of 5.2 years. After a mean of 4.9 years, activity levels were assessed using the University of California, Los Angeles (UCLA) activity scale via a questionnaire. Additionally, a detailed evaluation of sports behavior was conducted using an additional questionnaire. Pain and satisfaction with sporting ability were assessed using a visual analog scale (VAS). Complications and revisions were documented.
Patients had a mean WOMAC score of 98.0 (range, 60.0-100.0) and HHS score of 97.8 (range, 65.0-100.0) at final follow-up. The mean UCLA activity score was 4.7 (range, 2.0-10.0). An increasing number of patients were active in sports at follow-up compared with before surgery (76.5% vs 60.8%, respectively); 2 patients (3.9%) stopped participating in sports on a regular basis, and 10 (19.6%) commenced with sports after surgery. The most popular activities before surgery were cycling (31.4%), hiking (29.4%), swimming (21.6%), and fitness/weight training (15.7%). At follow-up, most patients were engaged in cycling (35.3%) and fitness/weight training (33.3%), followed by swimming (25.5%) and hiking (19.6%). The duration (hours per week) and frequency (times per week) of sporting activities remained stable. The mean VAS pain level during sports was 1.3 (range, 0.0-7.0). No revision surgery had to be performed.
After single-stage bilateral short-stem THA, the study patients returned to satisfying levels of activity at midterm follow-up. Postoperatively, few patients were engaged in high-impact sports; however, more patients commenced with lower impact activities. Satisfaction with sporting abilities was high, and the complication rate in total was low.
对于双侧髋关节关节炎患者，一期双侧全髋关节置换术（THA）是分期单侧THA的一种替代方案；然而，该手术的安全性和可靠性仍备受广泛关注。短柄THA近年来已出现。迄今为止，尚无关于一般患者人群一期双侧短柄THA术后运动和娱乐活动水平的数据。
接受一期双侧短柄THA的患者在中期随访时恢复到令人满意的运动和娱乐活动水平。
病例系列；证据等级，4级。
前瞻性纳入54例连续患者（108髋）。对51例患者（94.4%）进行了中期随访。平均5.2年后临床评估西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分和Harris髋关节评分（HHS）。平均4.9年后，通过问卷调查使用加利福尼亚大学洛杉矶分校（UCLA）活动量表评估活动水平。此外，使用另一问卷对运动行为进行详细评估。使用视觉模拟量表（VAS）评估运动时的疼痛和对运动能力的满意度。记录并发症和翻修情况。
末次随访时患者WOMAC评分平均为98.0（范围60.0 - 100.0），HHS评分平均为97.8（范围65.0 - 100.0）。UCLA活动评分平均为4.7（范围2.0 - 10.0）。与术前相比，随访时越来越多的患者积极参与运动（分别为76.5%对60.8%）；2例患者（3.9%）停止定期参加运动，10例患者（19.6%）术后开始运动。术前最受欢迎的活动是骑自行车（31.4%）、徒步旅行（29.4%）、游泳（21.6%）和健身/重量训练（15.7%）。随访时，大多数患者从事骑自行车（35.3%）和健身/重量训练（33.3%），其次是游泳（25.5%）和徒步旅行（19.6%）。体育活动的持续时间（每周小时数）和频率（每周次数）保持稳定。运动时VAS疼痛水平平均为1.3（范围0.0 - 7.0）。无需进行翻修手术。
一期双侧短柄THA术后，研究患者在中期随访时恢复到令人满意的活动水平。术后，很少有患者从事高冲击力运动；然而，更多患者开始进行低冲击力活动。对运动能力的满意度较高，总体并发症发生率较低。
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