Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany.
Department of Computer Science and Media, Brandenburg University of Applied Sciences, Magdeburger Straße 50, 14770, Brandenburg an der Havel, Germany.
BMC Musculoskelet Disord. 2021 Feb 27;22(1):230. doi: 10.1186/s12891-021-04099-7.
Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis. However, whether or not pre-operatively existing functional deficits are persisting several years post-surgery in the affected limb has not been thoroughly researched. Therefore, the primary aim of this preliminary study was to include patients four to five years after undergoing THA and to investigate potential differences between the operated and non-operated leg in hip strength, range of motion (ROM), balance, and gait. The secondary aim was to compare these values from the operated leg of the patients to those of the legs of healthy subjects.
Sixteen patients (age: 65.20 ± 5.32 years) following unilateral THA (post-operation time: 4.7 ± 0.7 years) and ten, healthy, age-matched control subjects (age: 60.85 ± 7.57 years) were examined for maximum isometric hip muscle strength, active ROM of the hip joint, balance and gait on both limbs. Paired t-tests were used to assess the inter-limb differences in the THA group. Analyses of covariance (ANCOVA) were performed to compare groups, using age as a covariate.
The analysis of inter-limb differences in patients following THA revealed significant deficits on the operated side for hip abduction strength (p = 0.02), for hip flexion ROM (p < 0.01) and for balance in terms of the length of center of pressure (COP) (p = 0.04). Compared to values of the control subjects, the patients demonstrated significantly reduced hip strength in flexion, extension and abduction (p < 0.05) on the operated leg as well as reduced ROM measures in hip flexion, extension and abduction (p < 0.05).
The first results of this explorative study indicated that inter-limb differences as well as reduced hip strength and hip ROM compared with control subjects were still present four to five years after THA. These persisting asymmetries and deficits in patients following THA may be one explanation for the decrease in health-related quality of life (HRQoL) seen in patients over the years after surgery. Further studies are required to replicate these findings with a larger sample size.
DRKS, DRKS00016945. Registered 12 March 2019 - Retrospectively registered.
全髋关节置换术（THA）是治疗终末期髋关节骨关节炎患者的有效方法。然而，术前存在的功能缺陷是否会在术后数年持续存在于受影响的肢体，尚未得到充分研究。因此，本初步研究的主要目的是纳入接受 THA 后 4 至 5 年的患者，并研究髋关节力量、活动范围（ROM）、平衡和步态方面患侧与健侧之间的潜在差异。次要目的是将患者患侧的这些值与健康受试者的腿部进行比较。
对 16 名接受单侧 THA（术后时间：4.7±0.7 年）的患者（年龄：65.20±5.32 岁）和 10 名年龄匹配的健康对照者（年龄：60.85±7.57 岁）进行检查，以评估双侧髋关节最大等长肌力、髋关节主动 ROM、平衡和步态。采用配对 t 检验评估 THA 组的肢体间差异。采用协方差分析（ANCOVA）比较组间差异，以年龄为协变量。
THA 患者肢体间差异分析显示，患侧髋关节外展力量（p=0.02）、髋关节屈曲 ROM（p<0.01）和平衡时的中心压力长度（COP）（p=0.04）存在显著缺陷。与对照组相比，患者患侧髋关节屈伸和外展力量（p<0.05）以及髋关节屈伸和外展 ROM 测量值（p<0.05）均显著降低。
本探索性研究的初步结果表明，THA 后 4 至 5 年，仍存在肢体间差异以及髋关节力量和 ROM 较对照组降低的情况。THA 后患者持续存在的这些不对称和功能缺陷，可能是术后多年患者健康相关生活质量（HRQoL）下降的一个原因。需要进一步的研究来用更大的样本量复制这些发现。
DRKS，DRKS00016945。2019 年 3 月 12 日注册-回顾性注册。
