强直性骨盆倾斜行全髋关节置换术后肢体长度对初期疗效的影响  

Short-term influnces of leg length inequality following total hip arthroplasty for patients with stiff pelvic obliquity

作　　者：赵枫[1] 吕辉照[1] 曹杰[1] 艾建国[1] 

机构地区：[1]解放军第180医院骨科,泉州362000

出　　处：《中华关节外科杂志（电子版）》2015年第3期37-40,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的研究在伴有强直性骨盆倾斜的全髋关节置换术中,患肢长度对下腰部及髋关节功能的初期影响。方法自2005年1月至2010年3月,本组采用全髋关节置换术治疗伴有强直性骨盆倾斜的股骨头无菌性坏死24例,测量术前术后骨盆倾斜角和患肢延长的长度,并采用视觉模拟评分法(VAS)对下腰部和髋关节疼痛进行评分,Oswestry功能障碍指数(ODI)评估下腰部功能,Harris髋关节评分标准评估髋关节功能。结果所有患者均在术后1年接受随访评估,手术前后骨盆倾斜角无统计学差异。术后下腰部VAS疼痛评分和ODI与术前比较均有统计学差异(P<0.01),且VAS分值和ODI均与下肢延长长度呈正相关(P<0.01)。术后患髋VAS疼痛评分,与术前比较有统计学差异(P<0.05);手术前后的Harris评分有统计学差异(P<0.01)。术后患髋VAS分值与下肢延长长度呈正相关(F=0.560,P<0.01);但术后Harris评分与下肢延长长度无统计学差异(F=0.072,P>0.05)。结论在伴有强直性骨盆倾斜的全髋关节置换术中,保持患肢现有长度,既有利于髋关节初期功能的改善,也有利于提高下腰部和患侧髋关节的满意度。Objective To analyze the short-term influences of leg length inequality on the therapeutic efficacy of total hip arthroplasty（ THA） for the patients with stiff pelvic obliquity. Methods From January 2005 to March 2010,24 patients with stiff pelvic obliquity underwent THA. The leg length and angles of pelvic obliquity were measured before and after the operation. The lower lumbar function was evaluated using visual analogue scales（ VAS） and Oswestry disability index,and the hip function was evaluated using VAS and hip Harris function scores. Results All patients were followed up for one year after the operation. No significant difference was found in the postoperative pelvic obliquity angles comparing with the preoperative ones. There were significant differences in the VAS score and ODI of lower lumbar between the pre-operation data and the post-operation data（ P〈 0. 01 and P〈 0. 01）; the VAS and ODI were positively correlated with the leg length（ P〈 0. 01）. There were significant differences in hip VAS score and Harris score between the pre-operative data and the post-operative data（ P〈 0. 05 and P〈 0. 01）. The hip VAS score was positively correlated with leg length（ P〈 0. 01）,but there was no correlation between Harris score and the leg length（ P〉 0. 05）. Conclusion Maintaining the leg length in THA for the patients with stiff pelvic obliquity was beneficial to improving the hip function and the satisfaction for the functions of lower lumbar and hip.

关 键 词：骨盆 关节强直 关节成形术 置换 髋 腿长不等 

分 类 号：R687.4[医药卫生—骨科学]