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全髋关节置换术后采用后外侧入路时的坐地能力及相关因素。

The ability and factors related with floor sitting after total hip arthroplasty with a posterolateral approach.

作者信息

Nawatthakul Anuchit, Hongnaparak Theerawit, Iamthanaporn Khanin, Yuenyongviwat Varah

机构信息

Orthopedics, Prince of Songkla University.

出版信息

Orthop Rev (Pavia). 2022 Jul 27;14(4):37072. doi: 10.52965/001c.37072. eCollection 2022.

DOI:10.52965/001c.37072
PMID:35910547
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9329058/
Abstract

BACKGROUND

Prosthesis dislocation following total hip arthroplasty (THA) is one complication that affects treatment outcome and increases the cost of treatment. Currently, many surgeons prohibit patients from performing floor-based activities; however, these prohibitions might affect the lifestyle of a number of patients.

OBJECTIVE

This study aimed to evaluate the ability of floor sitting after THA, and factors associated with this ability.

METHODS

This study was a retrospective cohort study, evaluating 240 patients who underwent THA with a posterolateral approach, in a single tertiary hospital. Patient demographic data, preoperative clinical data, prostheses type, and postoperative radiographic were extracted from the electronic medical records. Postoperative ability to perform floor sitting was evaluated at 6 months postoperatively.

RESULTS

There were 52 patients (21.66%) who were able to sit on the floor postoperatively. Multivariate logistic regression analysis showed independent association between three factors with ability to sit on the floor after surgery: pre-operative external rotation range of motion (OR 1.03; 95% CI, 1.01-1.06; P = 0.01), pre-operative Harris Hip Scores (OR 1.05; 95% CI, 1.01-1.10; P = < 0.01), pre-operative ability to sit on the floor (OR 10.2; 95% CI, 3.65-28.5; P = < 0.01).

CONCLUSION

There were a number of patients who could sit on the floor after THA. However, there were factors which were associated with this ability. Hence, these results could be useful for adjusted patient preoperative expectations, and did not preclude all patients to perform floor activities.

摘要

背景

全髋关节置换术(THA)后假体脱位是一种影响治疗效果并增加治疗成本的并发症。目前,许多外科医生禁止患者进行坐在地上的活动;然而,这些禁令可能会影响许多患者的生活方式。

目的

本研究旨在评估THA后坐在地上的能力以及与该能力相关的因素。

方法

本研究为回顾性队列研究,评估了一家三级医院中采用后外侧入路行THA的240例患者。从电子病历中提取患者人口统计学数据、术前临床数据、假体类型和术后影像学资料。术后6个月评估患者术后坐在地上的能力。

结果

有52例患者(21.66%)术后能够坐在地上。多因素逻辑回归分析显示,术后坐在地上的能力与三个因素独立相关:术前外旋活动范围(OR 1.03;95%CI,1.01 - 1.06;P = 0.01)、术前Harris髋关节评分(OR 1.05;95%CI,1.01 - 1.10;P = < 0.01)、术前坐在地上的能力(OR 10.2;95%CI,3.65 - 28.5;P = < 0.01)。

结论

有许多患者在THA后能够坐在地上。然而,存在与这种能力相关的因素。因此,这些结果可能有助于调整患者术前预期,并且并不排除所有患者进行坐在地上的活动。

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本文引用的文献

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Activity Recommendations After Total Hip and Total Knee Arthroplasty.全髋关节和全膝关节置换术后的活动建议。
J Bone Joint Surg Am. 2021 Mar 3;103(5):446-455. doi: 10.2106/JBJS.20.00983.
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A Protocol of Pose Avoidance in Place of Hip Precautions After Posterior-Approach Total Hip Arthroplasty May Not Increase Risk of Post-operative Dislocation.后路全髋关节置换术后采用姿势避免替代髋关节预防措施的方案可能不会增加术后脱位风险。
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Prevention of Dislocation After Total Hip Arthroplasty.全髋关节置换术后脱位的预防。
J Arthroplasty. 2018 May;33(5):1316-1324. doi: 10.1016/j.arth.2018.01.047. Epub 2018 Mar 7.
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Mobile bearing medial unicompartmental knee arthroplasty in patients whose lifestyles involve high degrees of knee flexion: A 10-14year follow-up study.生活方式需要高度屈膝的患者行活动平台内侧单髁膝关节置换术:一项10至14年的随访研究。
Knee. 2017 Aug;24(4):829-836. doi: 10.1016/j.knee.2017.05.004. Epub 2017 May 30.
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Removal of restrictions following primary THA with posterolateral approach does not increase the risk of early dislocation.采用后外侧入路进行初次全髋关节置换术后解除限制不会增加早期脱位的风险。
Acta Orthop. 2015;86(4):463-8. doi: 10.3109/17453674.2015.1028009. Epub 2015 Mar 9.
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Are Harris hip scores and gait mechanics related before and after THA?全髋关节置换术前后Harris髋关节评分与步态力学之间有关系吗?
Clin Orthop Relat Res. 2014 Nov;472(11):3452-61. doi: 10.1007/s11999-014-3886-1. Epub 2014 Aug 20.
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Inverted cup prosthesis to treat recurrent hip dislocation in frail elderly patients.
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Changes in the WOMAC, EuroQol and Japanese lifestyle measurements among patients undergoing total hip arthroplasty.接受全髋关节置换术患者的WOMAC、欧洲五维度健康量表及日本生活方式测量指标的变化
Osteoarthritis Cartilage. 2009 Jul;17(7):848-55. doi: 10.1016/j.joca.2008.11.012. Epub 2008 Nov 24.
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