膝关节骨性关节炎患者全髋置换术后下肢力线变化的研究

目的：研究膝关节骨性关节炎患者在行全髋置换术后下肢力线的变化。方法：选择患者共24例,均符合膝关节骨关节炎诊断,同时行同侧的髋关节置换术,分别测量患者手术前后下肢力线。结果：手术前后双侧髋关节偏心距差值、双侧长度差值及AR值差异均有统计学意义（P〈0.05）。手术前后患侧生理外翻角Ⅰ、Ⅱ及胫股冠状角、髋-膝-踝角差异有统计学意义（P〈0.05）,踝角、胫骨平台-骨干角差异无统计学意义（P〉0.05）。患者手术前后患侧膝关节活动度差异无统计学意义（P〉0.05）。结论：全髋关节置换术重建了患者的股骨偏心距,能一定程度改善下肢不等长,改变膝关节重力负荷中心。全髋关节置换术早期改变了下肢的力线,从而影响了膝关节负荷分布。

Study on force line changing of lower limbs after total hip arthroplasty of patients with knee osteoarthritis

Objective： To study the force line changing of lower limbs of patients with knee joint osteoarthritis after total hip arthroplasty. Methods： Choose 24 patients diagnosed with knee osteoarthritis,undergone total homolateral hip arthroplasty at the same time,and measure force line of lower limbs of patient before and after the surgery. Results： Before and after surgery,the D-value of bilateral hip arthroplasty eccentric distance,homolateral length and AR existed remarkable statistical differences（ P 〈 0. 05）. Before and after surgery,there existed statistical differences（ P 〈 0. 05） on the patient suffered from side of physiological valgus angle Ⅰ,Ⅱ and tibial angle of coronary and hip-knee-ankle. There was no statistical difference（ P 〉 0. 05） of ankle,tibial plateaubackbone angle. Before and after surgery,there was no statistical difference（ P 〉 0. 05） of mobility of ill side of the knee joint. Conclusion： Total hip arthroplasty rebuilds the thighbone eccentric distance,improves the unequal length of lower limbs in certain degree and changes center of gravity load of knee joint. Total hip arthroplasty changes the force line of lower limbs in early stage,thus it can influence the load distribution of knee joint.