Fuchs Michael, Hein Marie-Anne, Faschingbauer Martin, Sgroi Mirco, Bieger Ralf, Reichel Heiko, Freitag Tobias
Department of Orthopaedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Baden Württemberg, Germany.
J Clin Med. 2021 Mar 16;10(6):1235. doi: 10.3390/jcm10061235.
Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.
由于保留了股骨近端骨量并将软组织创伤降至最低，短柄植入物在全髋关节置换术（THA）中变得越来越重要。关于功能结果的假定优势尚未得到证实。我们假设使用短柄设计可增加外展肌力量。纳入了一项随机临床试验的70例连续患者。其中，67例患者在12个月后符合纳入标准。35例患者接受标准直柄，32例患者接受短柄股骨组件。所有手术均采用改良直接外侧入路。在术前、术后3个月和12个月评估髋外展肌的等长肌力。评估Harris髋关节评分（HHS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。三个月后，两组之间没有差异；外展力与术前初始值相当。12个月后，与术前基线值相比，短柄患者组的肌肉力量显著增加（直柄THA，0.09 Nm/kg±0.4，P = 0.32；短柄THA，0.2 Nm/kg±0.3，P = 0.004）。术后12个月两组的总HHS和WOMAC比较显示无显著差异。与传统柄THA相比，短柄THA术后12个月髋外展肌力量显著增加。
