Chung Haksun, Chung So Hak
Department of Orthopaedic Surgery, Kosin University College of Medicine, Busan, Korea.
Yeungnam Univ J Med. 2020 Jan;37(1):40-46. doi: 10.12701/yujm.2019.00325. Epub 2019 Sep 16.
Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint.
The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain.
Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain.
Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.
自从非骨水泥型股骨柄广泛应用以来，髋关节置换术后出现的疼痛已变得很常见。其特征性疼痛出现在大腿前外侧区域。本研究旨在基于髋关节术后前后位（AP）和侧位（Lat）X线片的测量来预测大腿前侧疼痛。
本研究纳入了2010年3月至2016年5月期间接受全髋关节置换术或双极半髋关节置换术且有完整临床资料的26例患者（29髋）。在手术当天、术后1个月和6个月拍摄患侧髋关节的AP和Lat X线片。排除X线片不合格的患者。测量股骨柄远端至最近皮质骨的距离。视觉模拟评分（VAS）≥6分的患者组被指定为大腿前侧疼痛患者。
性别、年龄、体重、身高、体重指数以及腰椎和股骨的骨密度对术后VAS评分无显著影响（p>0.05）。股骨柄与皮质骨之间存在接触与术后大腿前侧疼痛相关。
髋关节置换术后通常拍摄髋关节AP和Lat X线片以确认股骨柄的固定和对线情况。本研究中介绍的测量方法可用于预测髋关节置换术后大腿前侧疼痛。
