控制假体置入位置减小全髋关节置换术后下肢长度差异的效果  

The effect of controlling prosthesis placement position in reducing the leg length discrepancy after total hip arthroplasty

作　　者：陈旭 赵斌[1] CHEN Xu;ZHAO Bin(SectionⅡ,Dept of Orthopaedic Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院骨外二科,河南新乡453100

出　　处：《临床骨科杂志》2022年第6期791-795,共5页Journal of Clinical Orthopaedics

基　　金：河南省卫健委医学适宜技术推广项目(编号:SYJ2020072)。

摘　　要：目的探讨控制假体置入位置减小全髋关节置换术(THA)后下肢长度差异(LLD)的效果。方法将100例行THA的患者按照手术方法不同分为观察组(通过控制髋臼和股骨柄假体置入位置减少LLD的发生,48例)和对照组(通过克氏针固定标记辅助定位减少LLD的发生,52例)。比较两组临床LLD、影像学LLD、术后髋臼假体的外展角及前倾角、术后并发症发生情况。采用Harris评分评价患者髋关节功能恢复情况。结果患者均获得随访,时间6~12个月。(1)临床LLD、影像学LLD、术后髋臼假体的外展角及前倾角:两组比较差异均无统计学意义(P>0.05)。(2)术后LLD<5 mm的比例:观察组(100.0%)明显高于对照组(88.5%),差异有统计学意义(P<0.05)。(3)Harris评分:两组术后各时间点均较术前明显升高(P<0.05);术后各时间点及两组间比较差异均无统计学意义(P>0.05)。(4)术后并发症发生率:观察组明显低于对照组(P<0.05)。结论通过控制髋臼和股骨柄假体置入位置可将THA术后LLD控制在5 mm以内,并可减少术后并发症的发生。Objective To investigate the effect of controlling the prosthesis placement position in total hip arthroplasty(THA)to reduce the occurrence of leg length discrepancy(LLD).Methods According to different surgical methods,100 patients undergoing THA were divided into observation group(the occurrence of LLD was reduced by controlling the position of acetabulum and femoral stem prostheses insertion,48 cases)and control group(the occurrence of LLD was reduced by Kirschner wire fixation marker assisted localization,52 cases).Clinical LLD,radiographic LLD,abduction angle and anteversion angle of acetabular prostheses,and postoperative complications were compared between the two groups.The recovery of hip function was assessed by Harris score.Results All patients were followed up from 6 months to 12 months.(1)There were no significant differences between the two groups,including clinical LLD,radiographic LLD,and postoperative abductive angle and anterersion angle of acetabular prostheses(P>0.05).(2)The proportion of LLD<5 mm after operation:the observation group(100.0%)was significantly higher than the control group(88.5%),and the difference was statistically significant(P<0.05).(3)Harris score:at postoperative each time point,the scores of two groups were significantly increased than that before surgery(P<0.05);there was no significant difference between the two groups at each postoperative time point or between the two groups(P>0.05).(4)The incidence rate of postoperative complications:the observation group was significantly lower than the control group(P<0.05).Conclusions By controlling the placement position of the acetabulum and femoral stem prostheses,LLD after THA can be controlled to less than 5 mm,and the incidence of postoperative complications can be reduced.

关 键 词：全髋关节置换术 下肢长度差异 假体置入位置 

分 类 号：R687.4[医药卫生—骨科学] R687.3[医药卫生—外科学]