From the Rehabilitation Unit, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan (MM, MN, RH, TK, RI, SM); and Department of Orthopedic Surgery, Faculty of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan (KG, YK, RI, SM).
Am J Phys Med Rehabil. 2021 Jan 1;100(1):72-76. doi: 10.1097/PHM.0000000000001523.
The aim of this study was to identify which aspect of the preoperative lower limb functions is most likely to affect the functional mobility at 6 mos after total hip arthroplasty.
The study subjects included 125 women who underwent total hip arthroplasty. Hip flexion and abduction angles, hip abductor and knee extensor strengths, and lower limb load were measured preoperatively. The Timed Up and Go test was performed 6 mos postoperatively. Then, patients were divided into fast or slow groups as per the comparison with the Timed Up and Go score of healthy women.
Hip abductor strength and lower limb load on the nonoperative side were revealed as significant measurements that affected functional mobility after total hip arthroplasty according to stepwise multiple logistic regression analysis. Moreover, receiver operating characteristic curve analyses showed that the postoperative functional mobility was predicted by the lower limb load of the nonoperative side (cutoff point, 8.97 N/kg; sensitivity, 62.3%; specificity, 82.8%; and area under the curve, 77.5%).
This study revealed that patients with preoperative hip abductor strength of greater than 0.66 Nm/kg and lower limb load of greater than 8.97 N/kg on the nonoperative side could achieve better functional mobility at 6 mos postoperatively than healthy women of the same age group.
本研究旨在确定术前下肢功能的哪个方面最有可能影响全髋关节置换术后 6 个月的功能移动性。
研究对象包括 125 名接受全髋关节置换术的女性。术前测量髋关节屈曲和外展角度、髋关节外展肌和膝关节伸肌力量以及下肢负荷。术后 6 个月进行“起立-行走”测试。然后，根据与健康女性的“起立-行走”测试评分的比较，将患者分为快速或缓慢组。
根据逐步多元逻辑回归分析，髋关节外展肌力量和非手术侧下肢负荷是全髋关节置换术后功能移动性的重要测量指标。此外，受试者工作特征曲线分析显示，非手术侧下肢负荷（截断点为 8.97 N/kg；灵敏度为 62.3%；特异性为 82.8%；曲线下面积为 77.5%）可预测术后功能移动性。
本研究表明，术前髋关节外展肌力量大于 0.66 Nm/kg且非手术侧下肢负荷大于 8.97 N/kg的患者，术后 6 个月的功能移动性优于同年龄组的健康女性。
