Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Department of Orthopaedic Surgery, Toyohashi City Hospital, 50 Hakkennishi, Aotaketyo, Toyohashi, 441-8570, Japan.
Eur J Orthop Surg Traumatol. 2024 Aug;34(6):3319-3327. doi: 10.1007/s00590-024-04060-z. Epub 2024 Aug 20.
It is not uncommon for patients with hip disorders to present with pelvic obliquity (PO), and residual PO after total hip arthroplasty (THA) may not only affect hip joint function but also cause adjacent intervertebral joint disorders. This study aimed to investigate the postoperative PO impact on clinical outcomes and risk factors by comparing patients who had PO after THA to those who did not.
A single-center, retrospective cohort study was conducted. A total of 103 patients who underwent THA were included in this study from 2018 to 2020. Demographics, functional outcomes, and spinopelvic parameters were compared between post-THA PO of less than 2° (NT group, 55 patients) and PO of 2° or more (O group, 48 patients). Multivariate analysis was performed using factors with significant differences in univariate analysis.
Postoperative Harris Hip Score Activity was significantly lower in the T group than in the NT group (p = 0.031). Preoperative PO was smaller in the NT group than in the T group (p = 0.001). Preoperative lumbar bending range (LBR) was significantly more flexible in the NT group than in the T group. In the logistic regression analysis, Age (odds ratio 0.957, 95% CI 0.923-0.993, p = 0.020), preoperative PO (odds ratio 1.490, 95% CI 1.100-2.020, p = 0.001), and LBR (odds ratio 0.848, 95% CI 0.756-0.951, p = 0.005) were found to be significant factors.
Younger age and large preoperative PO, and poor lumbar spine mobility were identified as risk factors for residual postoperative PO.
髋部疾病患者常出现骨盆倾斜（PO），全髋关节置换术（THA）后残留 PO 不仅会影响髋关节功能，还会导致相邻椎间关节疾病。本研究旨在通过比较 THA 后存在 PO 和不存在 PO 的患者，探讨术后 PO 对临床结果的影响及相关危险因素。
采用单中心回顾性队列研究。纳入 2018 年至 2020 年 103 例接受 THA 的患者，比较 THA 后 PO 小于 2°（NT 组，55 例）和 PO 大于或等于 2°（O 组，48 例）患者的一般资料、功能结果和脊柱骨盆参数。对单因素分析中具有显著差异的因素进行多因素分析。
T 组术后 Harris 髋关节评分活动度明显低于 NT 组（p=0.031）。NT 组术前 PO 小于 T 组（p=0.001）。NT 组术前腰椎弯曲范围（LBR）明显更灵活。在逻辑回归分析中，年龄（比值比 0.957，95%可信区间 0.923-0.993，p=0.020）、术前 PO（比值比 1.490，95%可信区间 1.100-2.020，p=0.001）和 LBR（比值比 0.848，95%可信区间 0.756-0.951，p=0.005）是显著的影响因素。
年龄较小、术前 PO 较大、腰椎活动度较差被认为是术后残留 PO 的危险因素。
