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干预八年后微创或传统入路髋关节置换术后的功能恢复

Functional Recovery After Hip Arthroplasty with a Minimal Invasive or Classical Approach Eight Years After Intervention.

作者信息

Vuckovic Mirela, Ruzic Lana, Tudor Karlo, Prpic Tomislav, Jotanovic Zdravko, Segulja Silvije, Lekic Andrica, Bazdaric Ksenija

机构信息

Department of Physiotherapy, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 5, 51 000 Rijeka, Croatia.

Department of Sport and Exercise Medicine, Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia.

出版信息

J Funct Morphol Kinesiol. 2024 Oct 26;9(4):208. doi: 10.3390/jfmk9040208.

Abstract

The aim of this study was to investigate differences in functional recovery eight years after total hip arthroplasty in patients who underwent hip joint surgery using two different approaches: the classic lateral approach and the anterolateral minimally invasive surgical approach. Eight years after the hip replacement, 68 subjects, 32 in the classic and 36 in the minimally invasive group, underwent follow-up measurements involving the Harris Hip Score (HHS), range of motion, strength of the abductor muscles, 50-m walk time, body mass index (BMI), physical activity questionnaire, and visual analogue scale (VAS) pain during general activities. Higher HHS ( < 0.001), hip abduction ( < 0.001), and hip flexion ( = 0.018) range of motion values were obtained in the minimally invasive approach group. A correlation between physical activity (PA) and the hip abduction muscle strength in the classic group (r = 0.43; = 0.011) and a correlation between PA and the HHS in the minimally invasive group (r = 0.34, = 0.041) was found. BMI was correlated with the 50-m walk time in both groups (classical: r = 0.39; = 0.027; minimally invasive r = 0.35; = 0.030); meanwhile, in the minimally invasive group, BMI was negatively correlated with hip flexion (r = -0.37; = 0.020). Eight years after total hip arthroplasty, performed using either an anterolateral minimally invasive or lateral approach, there was no difference in the patients' functional outcome in relation to BMI. The minimally invasive approach benefits patients by granting them better functional abilities. A clinical difference was found in the HHS, in favour of the minimally invasive group.

摘要

本研究的目的是调查采用两种不同手术入路(经典外侧入路和前外侧微创外科入路)进行髋关节手术的患者在全髋关节置换术后八年的功能恢复差异。髋关节置换术后八年,68名受试者(经典入路组32名,微创组36名)接受了随访测量,包括Harris髋关节评分(HHS)、活动范围、外展肌力量、50米步行时间、体重指数(BMI)、体力活动问卷以及一般活动期间的视觉模拟量表(VAS)疼痛评分。微创入路组获得了更高的HHS(<0.001)、髋关节外展(<0.001)和髋关节屈曲(=0.018)活动范围值。在经典组中发现体力活动(PA)与髋关节外展肌力量之间存在相关性(r = 0.43;= 0.011),在微创组中发现PA与HHS之间存在相关性(r = 0.34,= 0.041)。两组中BMI均与50米步行时间相关(经典组:r = 0.39;= 0.027;微创组r = 0.35;= 0.030);同时,在微创组中,BMI与髋关节屈曲呈负相关(r = -0.37;= 0.020)。全髋关节置换术后八年,采用前外侧微创或外侧入路,患者的功能结局与BMI无关。微创入路通过赋予患者更好的功能能力而使其受益。在HHS方面发现了临床差异,微创组更具优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afd1/11587008/1967fbe1beb0/jfmk-09-00208-g001.jpg

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