非骨水泥型与骨水泥型全髋关节置换术对双下肢长度差及关节功能恢复的影响

Effects of cementless and cemented total hip arthroplasty on the length difference of lower limbs and recovery of joint function

目的探究非骨水泥型与骨水泥型全髋关节置换术(THA)对双下肢长度差及关节功能恢复的影响。方法选择2016年4月至2017年6月我院收治的76例THA患者为研究对象,随机将其分为研究组和对照组,每组38例。研究组采用非骨水泥型假体置换,对照组采用骨水泥型假体置换。比较两组患者的手术指标、手术前、后双下肢长度差及关节功能恢复情况。结果研究组患者的术中出血量明显少于对照组,手术时间明显短于对照组,差异均具有统计学意义(P<0.05);手术后6个月,两组患者的双下肢长度差均显著减小,且研究组明显小于对照组,差异均具有统计学意义(P<0.05);研究组患者的工具性日常生活活动能力(IADL)量表、生理性日常生活活动能力(PADL)量表及Harris髋关节功能量表评分均明显高于对照组,差异均具有统计学意义(P<0.05)。结论应用非骨水泥型假体进行THA可明显减少患者术中失血量,缩短手术时间,减小术后双下肢长度差,并促进患者关节功能的恢复,值得在临床上推广应用。

Objective To investigate the effect of cementless and cemented total hip arthroplasty （THA） on the lengthdifference of lower limbs and recovery of joint function. Methods A total of 76 patients undergoing THA in our hospitalfrom April 2016 to June 2017 were selected as the study objects and randomly divided into study group and controlgroup, with 38 cases in each group. The study group was treated with cementless prosthesis arthroplasty, and the controlgroup was treated with cemented prosthesis arthroplasty. The surgical indexes, length differences of lower limbs beforeand after surgery and recovery of joint function in the two groups were compared. Results The intraoperative blood loss ofthe study group was significantly less than that of the control group, the surgical time in the study group was significantlyshorter than that in the control group, the differences were statistically significant （P〈0.05）. At 6 months after surgery,the length differences of lower limbs significantly decreased in the two groups, and that in the study group wassignificantly less than the control group, and the differences were statistically significant （P 〈0.05）. The scores ofinstrumental activities of daily living （IADL） scale, physiological activities of daily living （PADL） scale and Harris hipfunction scale in the study group were significantly higher than those in the control group, and the differences werestatistically significant （P〈0.05）. Conclusion The application of cementless prosthesis for THA can significantly reducethe intraoperative blood loss, shorten the surgical time, reduce the the length difference of lower limbs and promote therecovery of joint function in patients. It is worthy of clinical promotion and application.