人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响

张红荣; 钟宝; 苗立帅; 张勇

doi:10.11659/jjssx.08E022049

您当前的位置：

首页 >

文章列表页 >

人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响

临床研究 | 更新时间：2023-05-26

- 人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响
- Effect of different lower limb length equalization strategies on hip function and postoperative bilateral lower limb length during artificial femoral head replacement
- 局解手术学杂志 2023年32卷第5期页码：404-408
- 作者机构：
  
  1.深圳市龙岗区人民医院创伤骨科，广东深圳 518000
  2.龙岗中心医院骨科,广东深圳 518116
  3.安康市中医医院骨科，陕西安康 725000
- 作者简介：
  
  张勇，E-mail：845896951@qq.com
- 基金信息：
  
  广东省医学科学技术研究基金项目(A201810113)
- DOI：10.11659/jjssx.08E022049
  中图分类号： R687.4
- 纸质出版日期：2023-05-25，
  
  收稿日期：2022-08-09，
扫描看全文
张红荣,钟宝,苗立帅等.人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响[J].局解手术学杂志,2023,32(05):404-408.

ZHANG Hong-rong,ZHONG Bao,MIAO Li-shuai,et al.Effect of different lower limb length equalization strategies on hip function and postoperative bilateral lower limb length during artificial femoral head replacement[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):404-408.
张红荣,钟宝,苗立帅等.人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响[J].局解手术学杂志,2023,32(05):404-408. DOI： 10.11659/jjssx.08E022049.

ZHANG Hong-rong,ZHONG Bao,MIAO Li-shuai,et al.Effect of different lower limb length equalization strategies on hip function and postoperative bilateral lower limb length during artificial femoral head replacement[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):404-408. DOI： 10.11659/jjssx.08E022049.

摘要

目的

探讨人工股骨头置换术中下肢长度不同均衡策略对髋关节功能及术后双下肢长度的影响。

方法

选取86例行单侧人工股骨头置换术的患者，根据术中采用的下肢长度均衡策略分为对照组和改良组，每组43例，对照组按照传统方法均衡下肢长度，改良组以健侧头颈比为对照均衡下肢长度。比较2组患者手术一般情况、手术前后双下肢长度差异、Harris评分、满意率、步态、并发症发生率。

结果

改良组手术时间、术中出血量、住院费用及住院时间等手术一般情况与对照组比较，差异均无统计学意义（

0.05）；2组术后双下肢长度差异均较术前缩小（

0.05），且改良组术后双下肢长度差异小于对照组（

0.05）；2组术后Harris评分均高于术前（

0.05），且改良组高于对照组（

0.05）；改良组满意率为97.67%，高于对照组的81.40%（

0.05）；改良组术后步频、单腿支撑时间、步速均高/长于对照组（

0.05）；改良组术后并发症发生率为2.33%，与对照组的6.98%比较，差异无统计学意义（

0.05）。

结论

人工股骨头置换术中以健侧头颈比为对照可有效均衡下肢长度，减少双下肢长度差异，增强髋关节功能重建效果，提升患者满意率，改善患者步态，安全可靠。

Abstract

Objective

To investigate the effects of different lower limb length equalization strategies during artificial femoral head replacement on hip function and postoperative bilateral lower limb length.

Methods

A total of 86 patients who underwent unilateral artificial femoral head replacement were selected and divided into the control group and the modified group according to different lower limb length equalization strategies adopted during the operation

with 43 cases in each group.The lower limb length in the control group was equalized by traditional method

and the lower limb length in the modified group was equalized by the head neck ratio of the healthy side.The general conditions of surgery

the difference of lower limb length before and after surgery

Harris score

satisfaction rate

gait and incidence of complications of the two groups were compared.

Results

There was no significant difference between the two groups in terms of operation time

intraoperative blood loss

hospital expenses or hospital stay (

0.05).The postoperative difference of lower limb length of the two groups were reduced compared with those before surgery (

0.05)

and the postoperative difference of lower limb length in the modified group was less than that in the control group (

0.05).The Harris scores after surgery in both groups were higher than those before surgery (

0.05)

and the modified group was higher than the control group (

0.05).The satisfaction rate in the modified group was 97.67%

which was higher than 81.40% in the control group (

0.05).The postoperative stride frequency

single leg support time and step speed in the modified group were higher/longer than those in the control group (

0.05).The postoperative incidence of complications in the modified group was 2.33%

which was no statistically significant difference compared with 6.98% in the control group (

0.05).

Conclusion

In artificial femoral head replacement

using the head neck ratio of the healthy side as a control can effectively equalize the the lower limb length

reduce the difference of bilateral lower limb length

enhance the effect of hip functional reconstruction

increase the patients' satisfaction rate

and improve the patients' gait

which is safe and reliable.

关键词

人工股骨头置换术下肢长度头颈比Harris评分满意率股骨颈骨折

Keywords

artificial femoral head replacementlower limb lengthhead neck ratioHarris scoresatisfaction ratefemoral neck fracture

references

Hong WK，Lee DJ，Chung H，et al.Patterns of femoral neck fracture and its treatment methods in patients with osteogenesis imperfecta［J］.J Pediatr Orthop B，2022，31（2）：e114-e121.doi：10.1097/BPB.0000000000000887http://dx.doi.org/10.1097/BPB.0000000000000887.

Chen AF，Barrington JW，Duwelius PJ，et al.Trends of femoral neck fracture treatment using total hip arthroplasty：reported from the American joint replacement registry［J］.J Am Acad Orthop Surg，2022，30（1）：e44-e50.doi：10.5435/JAAOS-D-21-00132http://dx.doi.org/10.5435/JAAOS-D-21-00132.

Vogt B，Gosheger G，Wirth T，et al.Leg length discrepancy：treatment indications and strategies［J］.Dtsch Arztebl Int，2020，117（24）：405-411.doi：10.3238/arztebl.2020.0405http://dx.doi.org/10.3238/arztebl.2020.0405.

Labott JR，Warne CN，Wyles CC，et al.Incidence of leg-length discrepancy after index hinge total knee arthroplasty［J］.J Arthroplasty，2021，36（5）：1607-1610.doi：10.1016/j.arth.2020.11.018http://dx.doi.org/10.1016/j.arth.2020.11.018.

Pheasant MS，Coulter JL，Wallace C，et al.Lumbar spine fusion and symptoms of leg length discrepancy after hip arthroplasty［J］.J Arthroplasty，2021，36（9）：3241-3247.doi：10.1016/j.arth.2021.05.006http://dx.doi.org/10.1016/j.arth.2021.05.006.

Kumar P，Sen R，Aggarwal S，et al.Reliability of modified Harris hip score as a tool for outcome evaluation of total hip replacements in Indian population［J］.J Clin Orthop Trauma，2019，10（1）：128-130.doi：10.1016/j.jcot.2017.11.019http://dx.doi.org/10.1016/j.jcot.2017.11.019.

中华医学会骨科分会关节外科学组，中国研究型医院学会运动医学专业委员会.步态图评估膝关节运动功能的专家共识（2020年版）［J］.中华关节外科杂志（电子版），2020，14（6）：651-656.doi：10.3877/cma.j.issn.1674-134X.2020.06.001http://dx.doi.org/10.3877/cma.j.issn.1674-134X.2020.06.001.

Rames RD，Hillen TJ，Pashos GE，et al.Incidence and characteristics of osteolysis in HXLPE THA at 16-year follow up in patients 50 years and less［J］.J Arthroplasty，2021，36（2）：641-646.doi：10.1016/j.arth.2020.08.048http://dx.doi.org/10.1016/j.arth.2020.08.048.

Iwakiri K，Ohta Y，Fujii T，et al.Changes in patient-perceived leg length discrepancy following total hip arthroplasty［J］.Eur J Orthop Surg Traumatol，2021，31（7）：1355-1361.doi：10.1007/s00590-021-02879-4http://dx.doi.org/10.1007/s00590-021-02879-4.

Zhang JS，Zheng YQ，Lin ZY，et al.Comparison of measurement methods of lower limb length in hip arthroplasty for femoral neck fracture［J］.Chin J Orthopa Trauma，2020，33（11）：1012-1016.doi：10.12200/j.issn.1003-0034.2020.11.005http://dx.doi.org/10.12200/j.issn.1003-0034.2020.11.005.

宋凯凯，杜刚强，李朋，等.头颈比法在人工股骨头置换治疗老年股骨颈骨折中的应用［J］.中国组织工程研究，2021，25（18）：2805-2809.

Gallo MC，Chung BC，Tucker DW，et al.Limb length discrepancy in total hip arthroplasty：is the lesser trochanter a reliable measure of leg length［J］.J Arthroplasty，2021，36（10）：3593-3600.doi：10.1016/j.arth.2021.06.009http://dx.doi.org/10.1016/j.arth.2021.06.009.

Anjiki K，Kamenaga T，Hayashi S，et al.Effectiveness of an accelerometer-based portable navigation for intraoperative adjustment of leg length discrepancy in total hip arthroplasty in the supine position［J］.J Orthop Sci，2022，27（1）：169-175.doi：10.1016/j.jos.2020.11.003http://dx.doi.org/10.1016/j.jos.2020.11.003.

Tone S，Hasegawa M，Naito Y，et al.Accuracy of image-free navigation in intraoperative leg length change from total hip arthroplasty using evaluations from 2D and 3D measurements［J］.BMC Musculoskelet Disord，2021，22（1）：1021.doi：10.1186/s12891-021-04906-1http://dx.doi.org/10.1186/s12891-021-04906-1.

Weber M，Meyer M，von Eisenhart-Rothe R，et al.The superiority of navigation and robotics in hip arthroplasty：fact or myth［J］.Orthopade，2021，50（4）：270-277.doi：10.1007/s00132-021-04079-8http://dx.doi.org/10.1007/s00132-021-04079-8.

Li Y，Wang XG，Dong ZY，et al.Effect of the acetabular cup positioning and leg length restoration after total hip arthroplasty using robotic-assisted surgery system［J］.Natl Med J China，2022，102（1）：43-48.doi：10.3760/cma.j.cn112137-20210716-01594http://dx.doi.org/10.3760/cma.j.cn112137-20210716-01594.

Ohmori T，Kabata T，Kajino Y，et al.Contralateral lower-limb functional status before total hip arthroplasty：an important indicator for postoperative gait speed［J］.J Bone Joint Surg Am，2021，103（12）：1093-1103.doi：10.2106/JBJS.20.00949http://dx.doi.org/10.2106/JBJS.20.00949.

Götze M，Hagmann S.Hip joint contractures，leg length discrepancies，and spinopelvic alignment：impact on the development of osteoarthritis of the hip［J］.Orthopade，2020，49（10）：877-882.doi：10.1007/s00132-020-03977-7http://dx.doi.org/10.1007/s00132-020-03977-7.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

成人股骨颈骨折术后股骨头坏死的多因素分析

空心钉与股骨颈动力交叉钉系统治疗Pauwels Ⅱ～Ⅲ型股骨颈骨折的疗效比较

股骨颈骨折空心加压螺钉内固定后股骨头坏死的相关因素

初次全髋关节置换治疗老年股骨颈骨折的效果及影响因素

微创PFNA-Ⅱ内固定术治疗老年不稳定型股骨粗隆间骨折的疗效观察