股骨偏心距改變對人工全髖關節置換術后關節疼痛及功能的影響研究_《中國修復重建外科雜志》

作者：

胥伯勇 , 楊德盛 , 艾力熱黑 , 曹力

新疆醫科大學第一附屬醫院骨科（烏魯木齊，830054）;

關鍵詞：

股骨偏心距人工全髖關節置換術關節疼痛關節功能

DOI：

10.7507/1002-1892.20130184

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目的探討人工全髖關節置換術后股骨偏心距的改變對術后關節疼痛和功能的影響。方法以2009年3月－2011年12月行單髖人工全髖關節置換術且符合選擇標準的162例患者作為研究對象，根據置換術后術側與健側偏心距差值分為3組，其中30例術側偏心距較健側 lt; —5 mm（減小組），87例術側與健側偏心距差值在—5～5 mm（正常組），45例術側偏心距較健側 gt; 5 mm（增加組）。3組患者性別、年齡、病程比較差異均無統計學意義（P gt; 0.05）。比較3組股骨柄及股骨頭假體類型，于手術前后采用12項簡明健康調查量表（SF-12量表）評分、美國西部Ontario與McMaster大學骨關節炎指數評分（WOMAC）、Harris評分標準評定臨床療效。結果3組使用標準偏心距股骨柄假體為主，擴展偏心距股骨柄假體次之，減少偏心距股骨柄假體最少；組間股骨柄及股骨頭假體類型比較差異均無統計學意義（P gt; 0.05）。患者均獲隨訪，隨訪時間12～33個月，平均25個月。術后1年3組間SF-12量表評分比較，差異無統計學意義（P gt; 0.05）；WOMAC評分中，3組間除軀體功能評分比較差異有統計學意義（P lt; 0.05）外，疼痛及僵硬評分比較差異均無統計學意義（P gt; 0.05）。髖關節功能根據Harris評分標準，減少組獲優13例，良8例，中7例，差2例；正常組獲優42例，良34例，中9例，差2例；增大組獲優31例，良12例，中2例；3組間比較差異有統計學意義（Z= —3.152，P=0.008）。結論在人工全髖關節置換術中，增大偏心距有利于術后關節疼痛的緩解以及功能恢復，偏心距減小可能會導致術后關節疼痛加重以及功能減退。

引用本文： 胥伯勇,楊德盛,艾力熱黑,曹力. 股骨偏心距改變對人工全髖關節置換術后關節疼痛及功能的影響研究. 中國修復重建外科雜志, 2013, 27(7): 843-846. doi: 10.7507/1002-1892.20130184 復制

1.	Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2012, 19(2): 112-115.
2.	Wik TS, Enoksen C, Klaksvik J, et al. In vitro testing of the deformation pattern and initial stability of a cementless stem coupled to an experimental femoral head, with increased offset and altered femoral neck angles. Proc Inst Mech Eng H, 2011, 225(8): 797-808.
3.	Chamnongkich S, Asayama I, Kinsey TL, et al. Difference in hip prosthesis femoral offset affects hip abductor strength and gait characteristics during obstacle crossing. Orthop Clin North Am, 2012, 43(5): e48-58.
4.	Brilhault JM, Ries MD. Posteriorly offset femoral component to restore anteroposterior position of the distal femur in revision total knee arthroplasty. J Arthroplasty, 2011, 26(2): 214-217.
5.	Cinotti G, Sessa P, Ripani FR, et al. Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau. J Anat, 2012, 221(5): 452-458.
6.	Malhotra R, Kannan A, Kancherla R, et al. Femoral head-neck offset in the indian population: A CT based study. Indian J Orthop, 2012, 46(2): 212-215.
7.	蘆北極, 孫俊英, 施勤, 等. 全髖關節成形術后的偏心距測量對臨床功能的影響. 中國矯形外科雜志, 2012, 20(14): 1282-1286.
8.	Malviya A, Lingard EA, Malik A, et al. Hip flexion after Birmingham hip resurfacing: role of cup anteversion, anterior femoral head-neck offset, and head-neck ratio. J Arthroplasty, 2010, 25(3): 387-391.
9.	Preininger B, Schmorl K, von Roth P, et al. Femoral offset (3D) in patients without osteoarthritis-index values from 200 hip joints. Open Orthop J, 2012, 6: 578-581.
10.	呂作剛, 孔榮. 股骨偏心距變化可影響髖關節置換后相關并發癥的發生. 中國組織工程研究, 2012, 16(13): 2309-2312.
11.	Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2011, 19(2): 112-115.
12.	Husby VS, Bjørgen S, Hoff J, et al. Unilateral vs. bilateral total hip arthroplasty—the influence of medial femoral head offset and effects on strength and aerobic endurance capacity. Hip Int, 2010, 20(2): 204-214.

1. Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2012, 19(2): 112-115.
2. Wik TS, Enoksen C, Klaksvik J, et al. In vitro testing of the deformation pattern and initial stability of a cementless stem coupled to an experimental femoral head, with increased offset and altered femoral neck angles. Proc Inst Mech Eng H, 2011, 225(8): 797-808.
3. Chamnongkich S, Asayama I, Kinsey TL, et al. Difference in hip prosthesis femoral offset affects hip abductor strength and gait characteristics during obstacle crossing. Orthop Clin North Am, 2012, 43(5): e48-58.
4. Brilhault JM, Ries MD. Posteriorly offset femoral component to restore anteroposterior position of the distal femur in revision total knee arthroplasty. J Arthroplasty, 2011, 26(2): 214-217.
5. Cinotti G, Sessa P, Ripani FR, et al. Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau. J Anat, 2012, 221(5): 452-458.
6. Malhotra R, Kannan A, Kancherla R, et al. Femoral head-neck offset in the indian population: A CT based study. Indian J Orthop, 2012, 46(2): 212-215.
7. 蘆北極, 孫俊英, 施勤, 等. 全髖關節成形術后的偏心距測量對臨床功能的影響. 中國矯形外科雜志, 2012, 20(14): 1282-1286.
8. Malviya A, Lingard EA, Malik A, et al. Hip flexion after Birmingham hip resurfacing: role of cup anteversion, anterior femoral head-neck offset, and head-neck ratio. J Arthroplasty, 2010, 25(3): 387-391.
9. Preininger B, Schmorl K, von Roth P, et al. Femoral offset (3D) in patients without osteoarthritis-index values from 200 hip joints. Open Orthop J, 2012, 6: 578-581.
10. 呂作剛, 孔榮. 股骨偏心距變化可影響髖關節置換后相關并發癥的發生. 中國組織工程研究, 2012, 16(13): 2309-2312.
11. Brilhault JM, Ries MD. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study. Knee, 2011, 19(2): 112-115.
12. Husby VS, Bjørgen S, Hoff J, et al. Unilateral vs. bilateral total hip arthroplasty—the influence of medial femoral head offset and effects on strength and aerobic endurance capacity. Hip Int, 2010, 20(2): 204-214.

《中國修復重建外科雜志》

股骨偏心距改變對人工全髖關節置換術后關節疼痛及功能的影響研究

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《中國修復重建外科雜志》

股骨偏心距改變對人工全髖關節置換術后關節疼痛及功能的影響研究

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