股骨偏心距和髋臼旋转中心对人工全髋置换术后关节功能影响的回顾性研究

Effect review of femoral offset and hip joint center on joint function after total hip replacement

[目的]通过股骨偏心距及髋臼旋转中心手术后测量,探讨其变化对人工全髋置换术后关节功能的影响。[方法]临床随访本院人工全髋置换术后患者87例(92髋),均为首次行全髋关节置换术患者,平均随访时间2年1个月,测量手术后双髋关节X线片,比较术后假体股骨偏心距、旋转中心与解剖股骨偏心距、旋转中心符合率,对患者术后髋关节功能进行Harris评分并分组进行统计学分析。[结果]股骨偏心距及髋臼旋转中心均恢复(A组)27例(29.35%),(B组)仅FO恢复23例(25.00%),(C组)仅HJC恢复31例(33.70%),(D组)FO及HJC均未恢复11例(11.96%),Harris评分优良率A组96.30%,B组为73.19%,C组为74.19%,D组为27.27%,Harris评分优良率A组与B组(P=0.039),A组与C组(P=0.029),A组与D组(P=0.000)差异均有统计学意义。[结论]股骨偏心距及旋转中心的恢复对人工全髋置换术后关节功能有直接影响。

[Objective] To study the effect of femoral offset and hip joint center on joint function after total hip replacement, radiographic measurements were taken postoperation. [ Method] A series of 92 hip joints （87 patients） were followed up. The average follow up priod was 25 monthes. The femoral offset and the position of the prothesis head center were measured in the orthophoric hip joint X - ray photograph and were compared with anatomic Fo and HJC. Harris evaluation system was used to evaluate joint function in four groups. The results were statistically analyzed, with Fisher＇ exact probability and P value less than 0. 05 indicating significant difference. [Result] The coincidence rate of group A （both FO and HJC, 27 hips） was 29. 35%, group B （only Fo, 23 hips） 25.00%, group C （only HJC, 31 hips） 33.70%, group D （neither FO nor HJC, 11 hips） 11.96%.93.0% patients got the Harris score more than 80 for group A, 73.19% （group B）, 74.19% （group C）, 27.27% （group D）. The difference of Harris evaluation between A and B, A and C, A and D was significant statistically. [ Conclusion] Based on the results of the study, the recovery of femoral offset and hip joint center should be considered to contribute to the healing effect after total hip replacement directly.