股骨偏心距在髋关节置换术中的影响

Influence of the Femoral Offset in the Operation of Hip Arthroplasty

目的通过临床资料收集明确股骨偏心距对髋关节置换术后的影响。方法以69例全髋关节置换术患者作为研究对象,根据置换术后术侧与健侧偏心距差值分为三组,分组依据是手术侧股骨偏心距和非手术侧股骨偏心距的差值。比较三组股骨柄及股骨头假体类型,并且于手术前后用各项评分系统对患者的临床表现进行SF-12量表、WOMAC及Harris评分。结果在假体类型方面得出:该手术中使用标准偏心距股骨柄假体为大多数,扩展偏心距股骨柄假体次之,减少偏心距股骨柄假体最少;三组之间的差异无统计学意义。三组实验患者均获随访,并且术后1年对三组间患者的SF-12量表评分比较,结果显示无显著性差异(P>0.05);WOMAC评分中,躯体功能评分之间差异有统计学意义(P<0.05)。髋关节功能根据Harris评分标准,得三组间优良率存在显著性差异。结论在人工全髋关节置换术中,适宜的增大偏心距有利于术后关节疼痛的缓解以及功能恢复,偏心距减小可能会导致术后关节疼痛加重以及功能减退。

Objective Analyze the The effects of altering patients’ femoral offset （FO） during total hip arthroplasty on postoperative pain and function. Methods This study compared clinical outcomes as assessed by the Short Form 12 Health Survey, Western Ontario and McMaster University Osteoarthritis Index and Harris between patients who had their FOs restored to varying degrees （compared to the contralateral normal hip [CL]）. We retrospectively measured postoperative FOs on standard anteroposterior pelvis radiographs and compared to the CL. Patients were categorized into one of 3 groups：decreased offset （N-4 mm compared to CL）, normal offset （between？4 and＋4 mm）, and increased offset （N＋4mm）. Results According to the results of the Short Form 12 Health Survey, Western Ontario and McMaster University Osteoarthritis Index and Harris, there are signiifcant differences between these three groups. The decreased offset group’s physical Function scores that were less than those of the normal offset and increased offset groups. In conclusion, reducing a patients’ native FO led to inferior functional outcome scores. Conclusions Increase in total hip arthroplasty, eccentricity is conducive to the postoperative joint pain relief and functional recovery, eccentricity reduce postoperative joint pain may lead to aggravate and functional impairment.