Takegami Yasuhiko, Seki Taisuke, Osawa Yusuke, Kusano Taiki, Makida Kazuya, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
Eur J Orthop Surg Traumatol. 2020 Dec;30(8):1411-1416. doi: 10.1007/s00590-020-02716-0. Epub 2020 Jun 15.
Some reports suggested that the status of the opposite-side hip affects clinical outcomes of unilateral total hip arthroplasty (THA) for hip osteoarthritis (HOA). This study aimed to determine whether unilateral THA could improve pain and movement of the non-operative hip.
The analysis included 195 patients divided into three groups according to contralateral hip status based on radiographic change assessed by Kellgren-Lawrence (KL) grade: normal hip (Group N: n = 124), HOA with KL grade > 2 (Group O: n = 39), and THA patients who already underwent THA in their opposite hip joint (Group T: n = 32). All patients were interviewed and examined preoperatively and at 1-year intervals after surgery. Hip function was evaluated with Harris Hip Score (HHS) and range of motion (ROM) preoperatively and at 1-year follow-up. We used the Japanese Orthopedic Association Hip-Disease Evaluation Questionnaire (JHEQ) and the Visual Analogue Scale (VAS) for separately evaluated right and left hip joints.
The mJHEQ movement, which indicated the activity, and flexion of ROM in the non-operative hip improved in group N and group T. The VAS and JHEQ pain values did not differ between preoperative and 1-year follow-up in all groups. In the operative side, HHS function, JHEQ movement values in group O were significantly lower than those of groups N and T at 1-year follow-up.
Unilateral THA may improve non-operative hip movement and active daily life except when the non-operated hip shows osteoarthritis. It did not improve non-operative hip pain, regardless of the condition on the other side. Clinical outcomes of unilateral THA may be affected by opposite hip status each other.
一些报告表明，对侧髋关节的状况会影响髋骨关节炎（HOA）单侧全髋关节置换术（THA）的临床结果。本研究旨在确定单侧THA是否能改善非手术侧髋关节的疼痛和活动情况。
分析纳入195例患者，根据Kellgren-Lawrence（KL）分级评估的影像学变化，将对侧髋关节状况分为三组：正常髋关节（N组：n = 124）、KL分级>2的HOA（O组：n = 39）以及对侧髋关节已接受THA的患者（T组：n = 32）。所有患者在术前及术后每隔1年接受访谈和检查。术前及术后1年随访时，采用Harris髋关节评分（HHS）和活动范围（ROM）评估髋关节功能。我们使用日本骨科协会髋关节疾病评估问卷（JHEQ）和视觉模拟量表（VAS）分别评估左右髋关节。
N组和T组非手术侧髋关节的mJHEQ活动度（表明活动情况）及ROM的屈曲度有所改善。所有组术前和术后1年随访时的VAS和JHEQ疼痛值无差异。在手术侧，术后1年随访时，O组的HHS功能、JHEQ活动度值显著低于N组和T组。
单侧THA可能改善非手术侧髋关节的活动情况及日常活动能力，但非手术侧髋关节存在骨关节炎时除外。无论对侧情况如何，单侧THA均不能改善非手术侧髋关节疼痛。单侧THA的临床结果可能会受到对侧髋关节状况的相互影响。
