股骨偏心距的变化对THA术后步态影响研究  

The research about the changes of the recovered femur offset how to influence the patient's gait after THA

作　　者：蔡海康[1] 汤杰[1] 刘夫海[1] 张银网[1] 朱伟红[1] 

机构地区：[1]上海市徐汇区中心医院,上海200031

出　　处：《陕西医学杂志》2017年第4期498-500,共3页Shaanxi Medical Journal

摘　　要：目的:研究股骨偏心距的变化对THA后步态影响。方法:对行THA的60例髋关节患者进行研究,通过X线摄片和三维步态分析系统,观察患者双下肢步态时间及距离参数,股骨偏心距与髋臼杯外展角、水平距离、股骨偏心距和颈干角的关系,股骨偏心距与髋外展肌等长收缩峰值(牛顿·米)及其与股骨偏心距的相关关系,并比较术前、术后Harris评分。结果:根据步态分析,手术侧单腿站立时间小于对侧,而跨距及踏步时间大于对侧,差异具有统计学意义(P<0.05);术后股骨距保留部分的长度与外展肌等长收缩最大肌力都与股骨偏心距存在相关性;此外Harris评分术前、术后差异有统计学意义(P<0.05)。结论:THA术中恢复髋关节原来的股骨偏心距是臀中肌能够进行有效的做功及患者不会出现跛行步态的前提条件。Objective：Study the changes of therestored femur offset how to influence the patient＇s gait after THA.Methods：60 patients with THA were studied by X-ray and three-dimensional gait analysis system.The gait time and distance parameters of the patients were observed.The eccentricity of the femur and the abduction of the acetabular cup Angle, horizontal distance, femoral offset and neck angle, the relationship between the eccentricity of femur and the isometric peak of hip abductor muscle （Newton-m） and its relationship with femoral offset, and compare the preoperative and postoperative Harris score.Results： According to the gait analysis, the standing time of one side of the operation was less than that of the contralateral side, and the span and step time were greater than the contralateral side, the difference was statistically significant （P〈0.05）;there was significant correlation between the length of retained part of femur and the maximal contraction strength of abductor muscle and the eccentricity of femur.The difference of Harris score before and after operation was statistically significant （P〈0.05）.Conclusion： During THA, restored theoriginal femoral offset is the premium condition for the gluteus medium muscle can effectively working, and there are no limping gaitpresent in patients post-operated.

关 键 词：关节成形术 置换 髋 @股骨偏心距 步态 

分 类 号：R684[医药卫生—骨科学]