Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Ramsay Santé, Lyon, France; Artro Institute, Lyon, France.
Artro Institute, Lyon, France; Department of Orthopaedic Surgery and Sports Medicine, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
J Arthroplasty. 2020 Dec;35(12):3656-3660. doi: 10.1016/j.arth.2020.07.009. Epub 2020 Jul 18.
Patients undergoing total hip arthroplasty (THA) frequently question surgeons on return to sports. We compared midterm sports participation and functional scores after THA by posterolateral approach (PLA) vs anterolateral approach (ALA).
Of 1381 patients who underwent uncemented ceramic-on-ceramic THA for primary osteoarthritis, 503 were excluded because of preoperative or postoperative lower limb surgery, leaving 594 operated by PLA and 284 by ALA. Forgotten Joint Score (FJS), Oxford Hip Score (OHS), satisfaction, as well as motivation, participation, and discomfort regarding 22 sports were collected. A 1:1 matching was performed to obtain 2 groups of PLA and ALA patients with similar age, gender, body mass index, and sports motivation.
Matching yielded 2 equal groups of 259 patients. There were no significant differences in FJS (P = .057), OHS (P = .685), satisfaction (P = .369), or rates of participation in light (P = .999), moderate (P = .632), or strenuous sports (P = .284). Participation in strenuous sports was reported by 50 PLA (19%) and 61 ALA (24%) patients, with differences for downhill skiing (22 vs 39), running (10 vs 19), and cross-country skiing (18 vs 10). More than 50% of motivated patients practiced most of their sports. Severe discomfort was reported similarly in PLA and ALA patients, mainly during running (13 vs 11), team ball games (9 vs 7), and downhill skiing (7 vs 8).
There were no significant differences between PLA and ALA patients in terms of OHS, FJS, satisfaction, or sports participation rates. There is little or no evidence to promote an approach based on sports participation or functional improvement.
Level III, comparative study.
接受全髋关节置换术（THA）的患者经常向外科医生询问有关重返运动的问题。我们比较了后外侧入路（PLA）与前外侧入路（ALA）THA 后的中期运动参与和功能评分。
在接受非骨水泥陶瓷对陶瓷 THA 治疗原发性骨关节炎的 1381 例患者中，有 503 例因术前或术后下肢手术而被排除在外，余 594 例采用 PLA 手术，284 例采用 ALA 手术。收集了遗忘关节评分（FJS）、牛津髋关节评分（OHS）、满意度以及 22 项运动的动机、参与度和不适度。进行了 1:1 匹配，以获得两组年龄、性别、体重指数和运动动机相似的 PLA 和 ALA 患者。
匹配得到 259 例患者的两组。FJS（P=0.057）、OHS（P=0.685）、满意度（P=0.369）或轻（P=0.999）、中（P=0.632）或剧烈运动（P=0.284）的参与率无显著差异。50 例 PLA（19%）和 61 例 ALA（24%）患者报告参加剧烈运动，差异主要在于下坡滑雪（22 比 39）、跑步（10 比 19）和越野滑雪（18 比 10）。超过 50%的有动力的患者练习了他们的大部分运动。PLA 和 ALA 患者的严重不适发生率相似，主要发生在跑步（13 比 11）、团队球类运动（9 比 7）和下坡滑雪（7 比 8）。
在 OHS、FJS、满意度或运动参与率方面，PLA 和 ALA 患者之间没有显著差异。几乎没有证据表明可以根据运动参与或功能改善来选择手术入路。
III 级，比较研究。
