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人工全髋关节置换术采用前外侧入路的患者的步态生物力学参数分析:基于髋关节假体头大小的回顾性配对队列研究。

Analysis of biomechanical gait parameters in patients after total hip replacement operated via anterolateral approach depending on size of the femoral head implant: retrospective matched-cohort study.

机构信息

Department of Orthopedics and Rehabilitation, Medical University of Warsaw, Warsaw, Poland.

3rd Clinic of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Arch Orthop Trauma Surg. 2022 Dec;142(12):4015-4023. doi: 10.1007/s00402-021-04264-6. Epub 2021 Nov 27.

Abstract

INTRODUCTION

Total hip replacement (THR) is considered one of the most effective medical procedures in treatment of osteoarthritis. Since its introduction, there has been a worldwide debate over proper implant selection in terms of size, bearing type and shape. Following study was designed to assess the importance of femoral head size in long-term follow-up.

MATERIALS AND METHODS

A cohort of 30 patients with primary end stage osteoarthritis who underwent total hip replacement was analysed retrospectively. A homogenous group was chosen with no major differences in BMI. Patients' gait parameters were measured in a biomechanics laboratory using the 3D BTS Smart system. WOMAC and VAS questionnaires were used to assess patient reported outcome.

RESULTS

The subgroup with larger implant head size had several outcomes significantly superior to the subgroup with standard head size and non-inferior to healthy hips. Following variables were measured during this study: time of support phase, time of swing phase, double support time, walking hip extension angle.

CONCLUSIONS

Use of larger sized femoral heads during THR gives better results in terms of gait pattern. Since restoring the gait pattern is one of the aspects of rehabilitation and returning to daily activities it seems to be an important observation.

摘要

简介

全髋关节置换术(THR)被认为是治疗骨关节炎最有效的医学手段之一。自问世以来,人们一直在全球范围内就假体的大小、轴承类型和形状等方面进行适当的假体选择展开争论。本研究旨在评估股骨头大小在长期随访中的重要性。

材料与方法

回顾性分析了 30 例接受初次全髋关节置换术的终末期原发性骨关节炎患者。选择了一个 BMI 无明显差异的同质组。患者的步态参数使用 3D BTS Smart 系统在生物力学实验室进行测量。采用 WOMAC 和 VAS 问卷评估患者的报告结果。

结果

大假体头组的几个结果明显优于标准假体头组,与健康髋关节相比非劣效。本研究测量了以下变量:支撑相时间、摆动相时间、双支撑时间、行走时髋关节伸展角度。

结论

在 THR 中使用较大的股骨头可改善步态模式,恢复步态模式是康复和回归日常生活的一个方面,因此这似乎是一个重要的观察结果。

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Head size in primary total hip arthroplasty.初次全髋关节置换术中的头部尺寸
EFORT Open Rev. 2018 May 21;3(5):225-231. doi: 10.1302/2058-5241.3.170061. eCollection 2018 May.

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