直接前方与后外侧入路进行全髋关节置换患者早期的步态变化  

Early gait changes after total hip arthroplasty through direct anterior approach and posterolateral approach

作　　者：王冲[1] 张梅莹 周健[2] 劳克诚 Wang Chong;Zhang Meiying;Zhou Jian;Lao Kecheng(Sports Medicine Rehabilitation Center,Qingdao Municipal Hospital,Qingdao University,Qingdao 266000,Shandong Province,China;Department of Bone and Joint and Sports Medicine,Qingdao Municipal Hospital,Qingdao University,Qingdao 266000,Shandong Province,China)

机构地区：[1]青岛大学附属青岛市市立医院运动医学康复中心,山东省青岛市266000 [2]青岛大学附属青岛市市立医院骨关节与运动医学科,山东省青岛市266000

出　　处：《中国组织工程研究》2022年第3期359-364,共6页Chinese Journal of Tissue Engineering Research

基　　金：青岛市市立医院新技术创新项目(2019-WJZD020),项目名称:侧卧位直接前入路人工全髋关节置换术的临床疗效观察,项目参与者:周健。

摘　　要：背景:全髋关节置换是治疗髋关节骨性关节炎的常用方法,直接前方入路与后外侧入路进行全髋关节置换均可获得良好的临床疗效,目前大量报道主要集中于两种手术入路的对比研究,用步态分析技术对患者全髋关节置换后早期步态变化的研究较少。目的:运用步态分析技术比较经直接前方与后外侧入路进行全髋关节置换手术患者术后早期不同时间段的步态变化,探讨两种手术入路术后早期的康复效果。方法:选择2019年9月至2020年6月于青岛市市立医院就诊的单侧髋关节骨性关节炎患者66例,采用随机数字表法分为2组,分别经直接前方入路进行全髋关节置换手术(n=33)、经后外侧入路进行全髋关节置换手术(n=33)。采用步态分析技术比较两组患者术前及术后1,3,6个月的步态变化。研究已通过青岛市市立医院伦理委员会审核。结果与结论:(1)术后1个月,直接前方入路组与后外侧入路组患者的跨步长、步速、步频、患侧支撑相较术前均有明显改善(P<0.05)。(2)术后3个月,两组患者的跨步长、步速、步频、患侧支撑相检测结果较术后1个月增加(P<0.05)。(3)术后6个月,直接前方入路组患者的跨步长、步速、步频、患侧支撑相检测结果与术后3个月时比较差异均无显著性意义(P>0.05),后外侧入路组患者的跨步长、步速、步频、患侧支撑相检测结果较术后3个月时增加(P<0.05)。(4)术后1,3个月时,直接前方入路组患者的跨步长、步频、步速、患侧支撑相检测结果优于后外侧入路组(P<0.05);术后6个月时,两组各指标比较差异无显著性意义(P>0.05)。(5)结果表明,两种手术入路都可使全髋关节置换患者获得明显的步态改善,直接前方入路可以更好地促进患者髋关节功能的恢复和早期锻炼。BACKGROUND:Total hip arthroplasty is a commonly used method for the treatment of hip osteoarthritis.Both direct anterior approach and posterolateral approach can achieve good results in total hip arthroplasty.The current research mainly focuses on the advantages and disadvantages of two surgical approaches.The use of gait analysis technology to study the early postoperative gait of patients is less.OBJECTIVE:The gait analysis technique was used to compare the gait changes of patients undergoing total hip arthroplasty with the direct anterior approach and the posterolateral approach in different time periods,and to explore the early postoperative rehabilitation effect of the two approaches.METHODS:The 66 patients with unilateral hip osteoarthritis who were treated with total hip arthroplasty at Qingdao Municipal Hospital from September 2019 to June 2020 were selected in this study,and divided into posterolateral approach group(n=33)and direct anterior approach group(n=33)according to the random number table method.The gait analysis technique was used to compare the changes of patients’gait in the two groups before surgery,1,3,and 6 months after surgery.This study was approved by Ethics Committee of Qingdao Municipal Hospital.RESULTS AND CONCLUSION:(1)At 1 month after surgery,stride length,pace,pace frequency and lateral support of patients in both groups were significantly improved compared with those before surgery(P<0.05).(2)At 3 months after surgery,stride length,pace,pace frequency,and lateral support were increased in the two groups compared with 1 month after surgery(P<0.05).(3)There was no statistical significance in stride length,stride speed,stride frequency,and support phase of the affected side in the direct anterior approach group at 3 and 6 months after surgery(P>0.05).The stride length,stride speed,stride frequency,and support phase of the affected side were increased in the posterolateral approach group at 6 months compared with that at 3 months(P<0.05).(4)At 1 and 3 months after surgery,the strid

关 键 词：全髋关节置换 直接前方入路 后外侧入路 步态分析 髋关节骨性关节炎 康复 

分 类 号：R493[医药卫生—康复医学] R319[医药卫生—临床医学]