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髋关节发育不良继发症状性髋关节骨关节炎患者初次全髋关节置换术后髋关节假体位置对术后步态的影响:一项短期随访研究。

Influence of hip prosthesis position on postoperative gait in symptomatic hip osteoarthritis secondary to hip dysplasia patients after primary total hip arthroplasty: a short-term follow-up study.

机构信息

Medical School of Chinese PLA, Beijing, 100039, China.

Department of Orthopedics, the First Medical Center of PLA General Hospital, Hospital, 28 Fuxing Road, Haidian District, Beijing, 100039, China.

出版信息

BMC Musculoskelet Disord. 2024 Oct 10;25(1):800. doi: 10.1186/s12891-024-07876-2.

DOI:10.1186/s12891-024-07876-2
PMID:39390448
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11465652/
Abstract

BACKGROUND

The aim of this study was to analyze the influence of the positioning of the components of total hip arthroplasty (THA) evaluated by the acetabular anteversion (AA) and femoral anteversion (FA) angle on postoperative gait in patients with symptomatic hip osteoarthritis secondary to hip dysplasia undergoing THA.

METHODS

Between May 2023 and May 2024, patients with symptomatic hip osteoarthritis secondary to hip dysplasia (Crowe Type I and IV) who underwent THA were enrolled in the study. The AA angle and FA angle were measured by computer tomography (CT). Gait data were determined by using the Dynamic Right Gait & Posture analysis system. The relationship between FA, AA and gait data was analyzed by Pearson correlation test, subgroup Pearson correlation test, multiple linear regression.

RESULTS

A total of 40 patients (45hips) were included in the study. Compared with preoperative, the patient's postoperative foot progression angle, foot contact angle, plantarflexion velocity, swing foot speed, gait velocity, cadence, stride length were significantly improved. Preoperative FA is significantly different from postoperative FA (P < 0.05), while the difference between preoperative and postoperative AA is not significant. BMI, Crowe Type, AA were related to change of cadence. The less the postoperative AA of patients, and the more the cadence in the postoperative gait of patients.

CONCLUSION

Our study showed that THA could improve the gait function of patients with symptomatic hip osteoarthritis secondary to hip dysplasia. Adjusting AA lower could obtain a much more postoperative cadence.

摘要

背景

本研究旨在分析全髋关节置换术(THA)中髋臼前倾角(AA)和股骨前倾角(FA)角度评估的组件位置对髋关节发育不良继发症状性髋关节骨关节炎行 THA 患者术后步态的影响。

方法

2023 年 5 月至 2024 年 5 月,纳入患有髋关节发育不良继发症状性髋关节骨关节炎(Crowe Ⅰ型和Ⅳ型)并接受 THA 的患者进行研究。通过计算机断层扫描(CT)测量 AA 角和 FA 角。使用动态右步态和姿势分析系统确定步态数据。通过 Pearson 相关检验、亚组 Pearson 相关检验、多元线性回归分析 FA、AA 与步态数据之间的关系。

结果

共纳入 40 例患者(45 髋)。与术前相比,患者术后足进角、足接触角、跖屈速度、摆动足速度、步态速度、步频、步长均显著改善。术前 FA 与术后 FA 明显不同(P < 0.05),而术前与术后 AA 差异无统计学意义。BMI、Crowe 分型、AA 与步频变化有关。患者术后 AA 越小,术后步态中步频越高。

结论

本研究表明,THA 可改善髋关节发育不良继发症状性髋关节骨关节炎患者的步态功能。调整较低的 AA 可获得更多的术后步频。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/a9d1ee1c6cf1/12891_2024_7876_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/559305add3ab/12891_2024_7876_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/fdc86e822432/12891_2024_7876_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/cd7ad7271435/12891_2024_7876_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/a9d1ee1c6cf1/12891_2024_7876_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/559305add3ab/12891_2024_7876_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/fdc86e822432/12891_2024_7876_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/cd7ad7271435/12891_2024_7876_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1759/11465652/a9d1ee1c6cf1/12891_2024_7876_Fig4_HTML.jpg

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J Funct Morphol Kinesiol. 2024 Jun 25;9(3):110. doi: 10.3390/jfmk9030110.
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Age-related changes and sex differences in ankle plantarflexion velocity.年龄相关变化和踝关节跖屈速度的性别差异。
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Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking.
股骨前倾角和颈干角对行走时肌肉力和关节载荷的影响。
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How Can Gait Analysis Improve Total Hip Arthroplasty?步态分析如何改善全髋关节置换术?
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Total Hip Arthroplasty in Patients with Crowe III/IV Developmental Dysplasia of the Hip: Acetabular Morphology and Reconstruction Techniques.全髋关节置换术治疗 Crowe III/IV 型髋关节发育不良患者:髋臼形态学和重建技术。
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Recovery Curves for Patient Reported Outcomes and Physical Function After Total Hip Arthroplasty.全髋关节置换术后患者报告结局和身体功能的恢复曲线。
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