Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital, Seoyang-ro 322, Hwasun-gun, Chonnam, 58128, Republic of Korea.
BMC Musculoskelet Disord. 2023 Oct 3;24(1):781. doi: 10.1186/s12891-023-06908-7.
Patients with ankylosing spondylitis often have fusions in the spine and sacroiliac joints, such that it is difficult to compensate for leg length discrepancy (LLD).
We retrospectively measured the LLD after total hip arthroplasty (THA) in 89 patients with ankylosing spondylitis from June 2004 to February 2021 at our institute. Patients were divided into two groups based on an LLD of 5 mm. Clinical outcomes were investigated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris Hip Score (HHS). In addition, these points are investigated: patient satisfaction with the operation; whether there was a current difference in leg length; and whether there was a limping gait.
The group with an LLD of 5-10 mm rather than < 5 mm had significantly worse WOMAC pain and stiffness. The survey revealed statistically significant differences in patient satisfaction with the operation, limping gait, and whether back pain had improved.
For patients with ankylosing spondylitis, reducing the LLD to < 5 mm, which is more accurate than the current standard of < 10 mm, may produce greater improvement in clinical outcomes after hip arthroplasty.
强直性脊柱炎患者的脊柱和骶髂关节常发生融合，使得下肢长度差异（LLD）难以代偿。
我们回顾性测量了 2004 年 6 月至 2021 年 2 月在我院接受全髋关节置换术（THA）的 89 例强直性脊柱炎患者的 LLD。患者根据 LLD 分为 5mm 组和 5-10mm 组。采用西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）和 Harris 髋关节评分（HHS）评估临床结果。此外，还调查了以下几点：患者对手术的满意度；是否存在当前的腿长差异；是否存在跛行步态。
LLD 为 5-10mm 组的 WOMAC 疼痛和僵硬评分明显较差。调查显示，手术满意度、跛行步态以及腰痛是否改善存在统计学差异。
对于强直性脊柱炎患者，将 LLD 降低至 <5mm（比当前的 <10mm 标准更准确）可能会在髋关节置换术后产生更大的临床结果改善。
