股骨偏心距重建对人工全髋关节置换术后功能的影响
The influence of restoring femoral offset on the function of hip after total hip arthroplasty
目的 分析重建股骨偏心距对人工全髋关节置换术后关节功能的影响。 方法 作者选择2005年01月至2008年01月间行初次单侧人工全髋关节置换术患者68例,随访时间9~24个月,平均19.2个月。手术均采用髋关节前外侧入路,使用Zweymüller双锥形螺旋臼及SL-PLUS矩形直柄(颈干角135°,股骨头假体的直径均为28 mm)。对比术前术后双髋关节正位X线片,测量股骨偏心距、髋外展肌力臂及双下肢长度,记录手术前后髋关节活动度及Harris评分,应用SPSS13.0统计软件分析股骨偏心距与其他指标的相关性。 结果 ①股骨偏心距与髋外展肌力臂具有正相关性(r=0.534,P<0.001)。②髋关节术后活动度、Harris评分与股骨偏心距均存在明显回归相关关系(r=0.403,0.344,P<0.001)。③股骨偏心距重建与否对下肢长度的影响存在显著性差异(x2=4.23,P<0.05)。 结论 在人工全髋关节置换术中,重建股骨偏心距可增加髋外展肌力,改善髋关节的活动功能及稳定性。
Objective To analyze the influence of restoring femoral offset on the function of hip after total hip arthroplasty (THA). Methods 68 patients underwent the primary and unilateral total hip arthroplasty were studied from January 2005 to January 2008. The mean follow-up period was 19.2 months, ranged from 9 to 24 months. A anterolateral approach was applied in all the procedures. Preoperative and postoperative femoral offset, the abductor lever arm and the leg length were compared through radiographic measurements, while, the ROM of hip and the Harris scores were recorded respectively. Statistical analysis were performed by SPSS13.0 software. Results Femoral offset correlated positively with the length of the abductor lever arm (r=0.534, P<0.001). Femoral offset was significantly positive related to the ROM of hip (r=0.403, P<0.001). Femoral offset was significantly positive related to the Harris scores (r=0.344, P<0.001). Restoration of femoral offset influenced the leg length (x2=4.23,P<0.05). Conclusions It is very important to restore femoral offset in THA, on the basis of improving the abductor strength, ROM and stability of hip.
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