Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, South Korea; Chosun University, School of Medicine, Gwangju, South Korea.
Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, South Korea.
J Arthroplasty. 2022 Sep;37(9):1809-1815. doi: 10.1016/j.arth.2022.04.001. Epub 2022 Apr 7.
The aim of this study is to validate the point of normalization of braking following total hip arthroplasty (THA) and to determine the relevance of the surgical approach.
Brake reaction parameters (BRPs), including brake reaction time, total brake time, and brake pedal depression force were measured in 90 patients who underwent primary arthroplasty of the right hip (42 with direct anterior approach and 48 with posterolateral approach) using a modern driving simulator. The driving parameters were measured preoperatively and every 2 weeks postoperatively until the eighth week. BRPs were measured in 40 subjects without hip problems, and the results were used as a control. Statistical assessment was performed to analyze when the patients' reaction to braking recovered to that of the control group with respect to different surgical approaches and also according to the pain.
Preoperative BRPs of the patients undergoing THA were prolonged compared to the control group and were normalized at the sixth week following the operation. Although BRPs of the direct anterior approach group showed significantly better improvement compared to the posterolateral approach group (total brake time at week 2, brake reaction time and brake pedal depression at week 4), both groups reached baseline value at week 6. In addition, we found no correlation between the pain score and BRPs.
The results of the current study indicate that the response to braking events normalizes at 6 weeks following THA in young active patients and is irrelevant to the surgical approach.
本研究旨在验证全髋关节置换术后(THA)制动的正常化点,并确定手术入路的相关性。
使用现代驾驶模拟器测量 90 例初次右髋关节置换术患者(42 例采用直接前入路,48 例采用后外侧入路)的制动反应参数(BRP),包括制动反应时间、总制动时间和制动踏板压力。术前和术后每 2 周测量一次,直至第 8 周。在 40 例无髋关节问题的受试者中测量 BRP,将结果作为对照组。采用统计学方法分析不同手术入路和疼痛对患者制动反应恢复至对照组的时间。
THA 患者术前 BRP 较对照组延长,术后第 6 周恢复正常。虽然直接前入路组的 BRP 改善明显优于后外侧入路组(第 2 周总制动时间、第 4 周制动反应时间和制动踏板压力),但两组均在第 6 周恢复至基线值。此外,我们发现疼痛评分与 BRP 之间无相关性。
本研究结果表明,年轻活跃患者在 THA 后 6 周内对制动事件的反应恢复正常,与手术入路无关。