术前功能对初次人工全髋关节置换术后早期功能的影响

Impact of preoperative function on early postoperative outcome after primary total hip arthroplasty

[目的]探讨术前功能状态对初次全髋关节置换术(THA)术后早期功能的影响。[方法]对2006年1月～2008年1月期间在本科行初次非骨水泥型全髋关节置换的髋关节骨性关节炎95例患者进行随访研究,其中男49例,女46例,平均年龄62.7岁(50～76周岁),随访时间大于24个月。根据患者术前Harris评分(HHS)将患者分为三组(A组,<45;B组45～55;C组>55),使用Harris评分、美国简明健康测量量表(SF-36)、西安大略大学和麦克马斯特骨关节炎指数(WOMAC)对患者术后6、12、24个月进行调查,并对组间同一时期和组内不同时期的评分结果进行统计学分析。[结果]A组患者在术后的HHS评分、SF-36、WOMAC中均表现出较差的结果,术后功能与术前HHS评分有关,而术后的活动度和畸形与之无关。[结论]术前较差的功能对术后患者早期功能恢复带来了不良的影响,同时延长了术后疼痛的时间。在功能下降的过程中较早实施THA可能会带来较好的术后功能。

[Objective]To investigate the impact of preoperative functional status on early postoperative outcomes after total hip arthroplasty（THA）.[Methods]Forty-nine men and 46 women aged 50 to 76 years who underwent cementless THA for osteoarthritis were followed up for at least 2 years.Patients were evaluated pre-and post-operatively（at 6,12,and 24 months） using the Harris Hip Score（HHS）,36-item Short Form Health Survey（SF-36）,and Western Ontario and McMaster University Osteoarthritis Index（WOMAC）.Patients were classifed into 3 groups based on their preoperative HHS（group A45;group B 45～55;and group C55）.Differences between and within groups were compared.[Results] Patients with a poor preoperative HHS had worse early postoperative outcomes in terms of HHS,SF-36,and WOMAC.Postoperative function was correlated with preoperative HHS,but postoperative range of motion and deformity was not.[Conclusion]Poor preoperative function may affect recovery unfavourably and lead to prolonged pain.Earlier THA in the course of functional decline may associate with better outcomes.