Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
Dipartimento Universitario Clinico Di Scienze Mediche, Chirurgiche E Della Salute, Universitá Degli Studi Di Trieste, Strada Di Fiume, 447, Trieste, Italy.
Sci Rep. 2021 Dec 1;11(1):23262. doi: 10.1038/s41598-021-02684-3.
The aims of this study were to (1) assess reliability of leg length discrepancy (LLD) measurements at different anatomical landmarks, (2) longitudinally investigate LLD in patients within the first year following total hip arthroplasty (THA) and to (3) correlate changes in LLD with functional outcome. Ninety-nine patients with short stem THA (53.3% males, mean age: 61.0 ± 8.1 years) were prospectively included. Upright pelvic anteroposterior (a.p.) radiographs taken at 6 timepoints (preoperatively, discharge, 6, 12, 24, 52 weeks postoperatively) were used to assess LLD at 5 anatomical landmarks (iliac crest, upper sacroiliac joint, lower sacroiliac joint, tear drop figure, greater trochanter). WOMAC and Harris Hip Score (HHS) were obtained preoperatively and at 6 and 52 weeks. LLD measures significantly increased in the initial phase following THA, from discharge to 6 weeks postoperatively and remained constant thereafter. Documentation of LLDs is dependent on measurement site: LLDs varied significantly between trochanter and iliac crest to tear drop figure (p < 0.001). Functional assessments did not correlate with the occurrence of LLDs [WOMAC (p = 0.252); HHS (p = 0.798)]. Radiographic assessment of LLD following THA may not be performed early postoperatively, as measurements appear to inaccurately reflect actual LLDs at this time, potentially due incomplete leg extension and/or inhibited weight-bearing.
(1)评估不同解剖标志处的肢体长度差异(LLD)测量的可靠性；(2)在初次全髋关节置换术(THA)后一年内对患者的 LLD 进行纵向研究；(3)并将 LLD 的变化与功能结果相关联。99 例短柄 THA 患者(男性 53.3%，平均年龄 61.0±8.1 岁)被前瞻性纳入研究。在 6 个时间点(术前、出院时、术后 6、12、24 和 52 周)拍摄了骨盆正位前后位(X 线片)，以评估 5 个解剖标志(髂嵴、上骶髂关节、下骶髂关节、泪滴图、大转子)处的 LLD。术前及术后 6 周和 52 周时分别进行 WOMAC 和 Harris 髋关节评分(HHS)。LLD 在 THA 后的初始阶段显著增加，从出院到术后 6 周，此后保持不变。LLD 的测量取决于测量部位：大转子和髂嵴之间至泪滴图之间的 LLD 差异有统计学意义(p<0.001)。功能评估与 LLD 的发生无关[WOMAC(p=0.252)；HHS(p=0.798)]。THA 后 LLD 的影像学评估可能不能在术后早期进行，因为此时的测量似乎不能准确反映实际的 LLD，这可能是由于下肢不完全伸展和/或负重受限。
