全髋人工关节置换术的肢体不等长

Leg length inequality after total hip arthroplasty

目的:探讨THA术恢复双下肢等长的重要性及方法.方法:对73例单侧THA术患者进行随访,随访时间21～76个月(平均38.9个月).X线片测量下肢的长短及股骨偏心距,对X线片测量数据进行统计学处理.结果:术后90.4%的患者(66例)出现下肢长度差别,两侧髋臼顶至泪滴连线距离差与肢体长度差存在明显负相关关系(r=-0.612,P<0.001),股骨偏心距与下肢长度差存在明显相关关系(r=0.434,P=0.003).结论:THA的肢体不等长问题不容忽视,强调术前肢体长度及模板测量,术中正确评估肢体长度,可获得满意结果.

Objective:To emphasize the importance and to find methods of restoring equal leg length during total hip arthroplasty(THA).Method:Seventy three patients undergone unilateral THA were evaluated.The mean duration of clinical and roentgenographic follow up was 38.9 months(ranged 21～76 months).The vertical distance from the teardrop line to the most prominent point of the lesser trochanter and femoral offset were measured from each radiograph.Result:There were 66 patients( 90.4% )with leg length discrepancy.The length discrepancy of distance from acetabular top to the teardrop line between both side correlated negatively with the leg length difference( r = 0.612; P <0.001).Simple regression analysis showed that femoral offset was significantly and positively related to the leg length discrepancy( r =0.434, P =0.003).Conclusion:Discrepancy of leg length must not be neglected in THA.It is very important to pay attention to careful preoperative templating of the affected and nonaffected hip and effective intraoperative leg length measurement.We can get satisfactory results.