仿生人工髋关节联合改良入路对肌力降低老年患者的康复意义  

On biomimetic artificial hip arthroplasty combined with modified operation approach for elderly patients with reduced muscle strength

作　　者：徐畅 于守业 马殿栋 张博 唐子滨 XU Chang;YU Shouye;MA Diandong;ZHANG Bo;TANG Zibin(Department of Orthopaedics,Jilin Provincial Corps Hospital of Chinese People's Armed Police,Changchun 130051,China;Department of Rehabilitation Medicine and Physiotherapy,Jilin Provincial Corps Hospital of Chinese People's Armed Police,Changchun 130051,China)

机构地区：[1]中国人民武装警察部队吉林省总队医院骨科,长春130051 [2]中国人民武装警察部队吉林省总队医院康复医学与理疗科,长春130051

出　　处：《科技导报》2023年第23期56-63,共8页Science & Technology Review

摘　　要：老年人群常存在肌力降低的情况,常规髋关节置换术后存在脱位风险。以肌力降低、存在术后脱位风险的老年股骨颈骨折患者为对象,通过前瞻性队列研究,旨在明确仿生髋关节置换结合改良Hardinge入路对肌力降低老年患者的安全性、功能康复及预后生活自理能力(ADL)的影响。指标包括:髋关节Lovett肌力分级、活动度(ROM)、髋关节功能的Harris评分、预后Barthel ADL评分。结果显示,患者出院当天、术后3个月、6个月的患侧髋关节在各方向的ROM均与健侧无差异,术后3个月、6个月的Harris评分、肌力、Barthel ADL评分均与骨折前/健侧无差异,患者在随访期间均未出现术后脱位。说明双动仿生髋关节结合改良Hardinge入路具有促进早期康复的作用,在保证髋关节正常ROM的同时,避免肌力降低的老年患者发生术后脱位,患者术后3个月即可恢复至骨折前的髋关节功能及生活自理能力。Decreasing muscle strength is very common in the elderly population,leading to the risk of dislocation after hip arthroplasty.The purpose of this prospective cohort study was to determine the effects of biomimetic artificial hip arthroplasty combined with the modified Hardinge approach on safety,functional rehabilitation,and prognostic activity of daily living(ADL)in the elderly patients with decreasing muscle strength.Indicators included the Lovett muscle strength grading of the hip joint,hip range of motion(ROM),Harris score of hip joint function,and Barthel ADL score for the prognosis.The results showed that there were no differences in hip ROMs between the affected side and contralateral side from the discharging day,to 3 months,to 6 months after surgery,that there were no differences in the Harris scores,muscle strengths,and Barthel ADL scores between the affected side and pre-injury/contralateral side from 3 to 6 months after surgery,and that all of the patients did not experience postoperative dislocation during the follow-up.It suggests that the biomimetic hip arthroplasty combined with the modified Hardinge approach has the effects of promoting early rehabilitation,ensuring normal ROM,while avoiding the postoperative dislocation in elderly patients with decreasing muscle strength,and that patients can restore the pre-injury hip function and ADL within 3 months in post-operation.

关 键 词：老年患者康复评定 预后生活自理能力 老年肌减少症 双动仿生髋关节 髋关节置换术后脱位 改良HARDINGE入路 HARRIS评分 

分 类 号：R687.4[医药卫生—骨科学]