围手术期功能锻炼对老年全髋关节置换术患者功能康复的影响

①目的探讨围手术期功能锻炼对改善老年髋关节骨关节炎（OA）患者全髋关节置换术（THA）术后早期行走功能的临床有效性和安全性。②方法选取我院骨科2011年5月～2012年3月问接受全髋关节置换术的老年OA患者38例,随机分为观察组和对照组。观察组在术前即开始执行已定制好的围手术期锻炼计划一直持续至术后2周;对照组只接受常规的围手术期护理和宣教。在术后2周对两组患者进行25米步行测试,测出两组患者手术前后的步态参数（步长、步速、步频）。③结果在术后2周,两组患者的平均步频和平均步速相比有统计学差异（P〈0．05）。（多结论围手术期功能锻炼可改善老龄0h患者全髋关节置换术后2周的行走功能。     

功能锻炼对THA患者术后早期行走功能的影响

目的探讨功能锻炼对全髋关节置换术(THA)患者术后早期行走功能的影响。方法将120例拟行THA的老年骨关节炎患者随机分为观察组和对照组各60例,对照组接受常规治疗和护理,观察组在此基础上实施为期3个月包括术前、术后功能锻炼在内的围手术期锻炼计划。比较两组患者干预前后的25m步行测试步态参数和6min最大行走距离。结果术后3个月观察组的平均步频、步长、步速和平均最大行走距离明显高于对照组,差异有统计学意义,均P0.01(t=11.761,2.766,4.595,13.201)。结论围手术期功能锻炼计划可显著改善老年骨关节炎患者THA术后的行走功能。     

不同类型膝关节假体在膝关节置换中应用效果

目的 探究膝关节假体在膝关节置换中的应用效果。方法 选取我院收治的104例单侧膝骨关节炎（KOA）患者，按随机数字表法分成观察组和对照组，每组52例。两组均行人工膝关节置换术（TKA），其中对照组采用后稳定型（PS）膝关节假体治疗，观察组采用内轴型（MP）膝关节假体治疗。对比两组手术前后视觉模拟评分法（VAS）、美国特种外科医院膝关节功能（HSS）评分、膝关节活动度、三维步态（步速、步频、跨步长比率）及并发症发生率。结果 同组术后1、3、6个月与术前比较，VAS评分均明显降低（P<0.05）,HSS评分均明显升高（P<0.05），但组间比较，P均>0.05。同组术后1、3、6个月与术前膝关节活动度比较，P均>0.05；且组间比较，P均>0.05。同组术后1、3、6个月步速、步频及跨步长比率与术前比较均明显升高（P均<0.05），且观察组升高幅度更为显著，两组比较，P均<0.05。两组治疗期间均未发生明显严重并发症。结论 MP、PS膝关节假体应用于TKA治疗KOA患者均能有效减轻疼痛感，提高膝关节功能，且对膝关节活动度无明显影响，但前者在改善三维...     

老年股骨颈骨折股骨头置换术后综合训练对行走能力的影响

目的:探讨综合训练对改善老年股骨头置换术后患者行走能力的影响,促进人工股骨头置换术后髋关节的早日康复。方法:将40例我院骨科接受人工股骨头置换术的老年股骨颈骨折患者依据入院顺序分为两组,治疗组患者按照综合训练内容进行训练,持续至术后12周;对照组患者仅按常规要求进行术后训练。结果:术后3个月治疗组患者25m的步频、步长、步速功能及6min最大步行距离明显优于对照组(P<0.05)。结论:综合训练能显著改善患者的行走能力,有助于患者髋关节功能的康复,促进了患者的自理能力恢复。     

成人型脊柱畸形患者运动功能的三维步态分析

目的 利用三维步态分析系统定量分析成人型脊柱畸形患者(adult spinal deformity,ASD)的步态特征,进一步熟悉ASD患者下肢功能的病理生理变化,为ASD患者的临床诊疗和术后康复提供理论依据。方法 纳入ASD患者51例作为病例组,并根据病例组患者一般情况(性别、年龄、体质量指数、及基础疾病)选出51例健康中老年患者作为对照组。记录所有研究对象的生活质量评分(Healthy Related Questionnaire of Life, HRQOL),包括视觉模拟评分(Visual Analogue Score, VAS)、Oswestry功能障碍指数(Oswestry Disability Index, ODI)及简版生活质量量表-36(Short Form-36,SF-36)评分。使用步态分析系统记录运动学参数。受试者骨盆及下肢特定的位置放置标记后在设定路线内以个体舒适步速行走,至少记录10个步态周期。采用SPSS 23.0软件分析参数。结果 与对照组相比,ASD患者下肢步长、跨步长、步频明显减小,且行走过程中呈逐渐减慢趋势;ASD患者髋、膝关节屈伸活动范围明显减小,组间比较差异均有统计学意义(P<0.05)。ASD患者生活质量评分中的VAS、ODI与步长、跨步长、步频、膝关节屈伸及髋关节屈伸度呈负相关关系(P<0.05);SF-36中的生理部分(Physical Component Summary, PCS)与上述指标呈正相关关系(P<0.05)。结论 ASD患者跨步长、步长、步频、膝关节屈伸活动度、及髋关节屈伸活动度均减小,且活动中逐渐减小;ASD患者生活质量与运动学参数密切相关。     

基于卡伦康复系统的盲人步态研究分析

目的分析盲人步态的特点,为持续性研究盲人定向行走提供基线数据。方法使用卡伦康复系统分析20名盲人的步态时空参数和步态平衡,比较与明眼人步态的差别。结果盲人双脚自身的步态时空参数对比差异无统计学意义(P>0.05);明眼人组步速(1.19±0.76)m/s,盲人组步速(0.90±0.22)m/s,差异有统计学意义(P<0.05);明眼人组步频(112.48±5.99)步/min,盲人组步频(32.95±2.28)步/min,差异有统计学意义(P<0.05);明眼人组左右脚的步长分别为(0.63±0.05)、(0.64±0.05)m,盲人组左右脚的步长分别为(0.49±0.09)、(0.49±0.10)m,差异有统计学意义(P<0.05);明眼人组双支撑相(31.28±1.23)%,盲人组双支撑相(33.75±0.98)%,差异有统计学意义(P<0.05)。结论盲人自身步态对称,与明眼人行走步态存在差异,步态平衡下降,此结论有助于改进盲人步态训练的方法和思路,为提升盲人定向行走提供了一定参考。     

不同入路方式全髋关节置换后早期步态分析差异化特征分析

目的：探究不同入路方式全髋关节置换后患者早期步态分析差异化特征。方法：前瞻性选取2020年2月—2022年2月于川北医学院附属医院骨科行全髋关节置换术的163例患者为研究对象,按随机数字表法分组,前入路组81例患者采用直接前入路方式,侧入路组82例患者采用外侧入路。比较两组患者术前术后的步态参数、Harris髋关节功能评分及视觉模拟评分法（VAS）评分。结果：前入路组、侧入路组术后1、3、6个月的步态参数（步长、步速、步频）、患肢单支撑时间、单支撑时间占步态周期百分比、Harris髋关节功能评分均有改善,SI、VAS评分水平均下降,差异均有统计学意义（P<0.05）;且术后1、3个月,前入路组指标改善均优于侧入路组,差异均有统计学意义（P<0.05）;术后6个月,前入路组与侧入路组在上述参数方面的差异均无统计学意义（P>0.05）。结论：直接前入路和外侧入路进行全髋关节置换术均能有效改善患者的髋关节功能和步态参数,缓解患者疼痛不适。术后3个月直接前入路方式患者步态恢复程度和髋关节恢复程度均明显优于外侧入路,术后6个月后两种入路方式患者恢复情况无明显差异。     

人工全髋关节置换术围手术期护理

目的:探讨人工全髋关节置换术围手术期护理方法与效果。方法:行人工全髋关节置换术的骨关节炎患者220例,根据护理方法的不同分为观察组与对照组各110例,观察组执行已定制好的围手术期护理计划,主要为肌力锻炼、行为锻炼与活动度锻炼,对照组患者接受护士给予的一般性指导。结果:观察组在术后12周的平均最大步行距离多于对照组(t=10.107,P<0.05)。观察组在术后12周的步频和步速均较对照组增加(t=9.621、10.252,P<0.05)。结论:人工全髋关节置换术围手术期护理价值重大,应建立一种连续的健康指导和长期的护理制度,以提高生活质量。     

直接前入路与后外侧入路半髋置换术治疗高龄患者股骨颈骨折

目的:对比半髋关节置换术治疗高龄股骨颈骨折患者中应用侧卧位直接前入路(DAA)与后外侧入路的中短期疗效。方法:将40例高龄股骨颈骨折患者随机分成DAA组及对照组,患者均接受人工双极头生物型假体半髋关节置换术,DAA组采用侧卧位直接前入路,对照组采用后外侧入路,分析比较两组患者的疗效。结果:两组患者手术时间差异无统计学意义(P>0.05);DAA组患者术中出血量、术后血红蛋白下降值、卧床时间及住院时间均少于对照组患者(P<0.01);DAA组患者术后1周及术后1个月时髋关节Harris评分高于对照组患者(P<0.01);术后1、3、7 d,DAA组患者VAS得分均低于对照组患者(P<0.01);术后6个月内,DAA组患者并发症发生率低于对照组患者(P<0.05)。结论:在半髋关节置换术治疗高龄股骨颈骨折患者中应用DAA的中短期疗效优于后外侧入路,能够促进患者快速康复。     

三维步态分析仪对中医经筋疗法治疗膝关节置换术后 疗效的研究

目的利用三维步态分析仪测量下肢步态参数,评价中医经筋疗法对膝关节置换术后患者膝关节功能恢复的疗效。方法招募因单侧膝骨关节炎行单侧膝关节置换术患者20例,每天接受中医经筋疗法,一共治疗4周。使用三维步态分析仪对患者治疗前及治疗后4周进行步态评估,记录步态特征中的时间空间参数(步长、步宽、步幅、步速、步频)、运动学(膝关节的角度、速度、角速度、加速度等)、动力学(地面反力、关节受力、力矩等)、肌电活动等多方面参数并进行分析。结果经筋疗法治疗后患侧步幅、步频、步速、患侧单腿支撑时间均较对照组明显增加(P 0.05)。治疗后步长、步速指标与治疗前相比,差异有显著性(P 0.05);治疗后承重反应期最大屈膝角度、支撑相中期最大伸膝角度、摆动相最大屈膝角度均较治疗前明显增加(P 0.05);治疗后可见矢状面第1次、第2次最大伸膝力矩较治疗前明显增加(P 0.05),矢状面的最大屈膝力矩与治疗前比较减小(P 0.05)。结论三维步态分析可以精确测量膝骨关节炎膝关节置换术后患者的步态参数,中医经筋疗法可以改善膝关节活动度。     

Changes in gait parameters in total hip arthroplasty patients before and after surgery.

BACKGROUND: The ideal outcome in total hip arthroplasty (THA) with endoprosthesis is the elimination of pain and the recovery of a normal range of movement in the affected hip joint, which is essential in order to improve the gait and restore the quality of life. In rehabilitation programs aimed at teaching patients to walk after THA, it is of particular importance to restore proper gait rhythm, speed, and fluidity of motion. MATERIAL/METHODS: We examined 30 patients with degenerative changes of the hip joint (11 men, 19 women), who had been referred for THA in the period 2002--2004 due to unilateral degeneration of the hip joint. Pedobarography was used to record the distribution of force on the foot in each patient just before and again one month after surgery, along with clinical tests to measure the range of motion (ROM) for both lower extremities. The body mass index (BMI) was also measured. RESULTS: Static measurements showed that before surgery there was no statistically significant asymmetry between the affected and healthy lower limbs in respect to maximum foot-ground pressure. One month after surgery, however, we found some asymmetry, caused by reduced load on the operated limb. After THA there was a slight increase in step length in both limbs, but asymmetry in step length persisted. CONCLUSIONS: One month after THA with endoprosthesis we observed slight improvement in step length and increased asymmetry in load-bearing in the affected limbs.     

肘关节镜下松解治疗肘关节僵硬的临床疗效

目的 初步探究肘关节镜下松解治疗肘关节僵硬的效果。方法 选取2018年6月1日至2021年5月31日行关节镜下肘关节松解的患者30例,其中男性19例,女性11例,年龄26~65岁,平均（45.6±4.3）岁。按照O'Driscoll四步法对肘关节僵硬进行松解,术后肘关节常规冰敷1周,术后第1天佩戴铰链支具,指导下进行屈伸功能锻炼。记录术前、术后1周、1个月、3个月肘关节的屈伸活动,比较术前与术后3个月患者肘关节活动度（range of motion,ROM）的变化,使用Mayo评分标准评价患肘功能恢复情况。结果 术后随访29例,失访1例,随访9~12个月,平均（10.6±1.4）个月。所有患者术后均未出现神经损伤症状、切口感染、肘关节异位骨化等并发症。肘关节平均最大ROM：术前63.30°±21.20°,术后1周77.82°±13.75°、术后1个月85.52°±11.32°、术后3个月110.19°±10.18°,术后1周、1个月、3个月的平均最大ROM与术前比较,差异均有统计学意义（P<0.05）。肘关节Mayo评分：术前（52.34±14.32）分、术后1周（63.48±10.35）分、术后1个月（73.44±8.77）分、术后3个月（80.43±13.74）分,术后1周、1个月、3个月的肘关节Mayo评分与术前Mayo评分比较,差异均有统计学意义（P<0.05）。结论 肘关节镜下松解治疗肘关节僵硬可改善肘关节活动度,早期促进肘关节功能恢复,利于早期开展功能锻炼和提高临床疗效。     

不同手术方式对移位性股骨颈骨折患者髋关节活动度、免疫炎性反应及凝血—纤溶系统的影响

目的 探讨不同手术方式对移位性股骨颈骨折患者髋关节活动度、免疫炎性反应及凝血-纤溶系统的影响。 方法 前瞻性选择移位性股骨颈骨折患者92例,根据治疗方案分为全髋关节置换术（total hip arthroplasty,THA）组48例和人工股骨头置换术（hemiarthroplasty,HA）组44例。比较2组围手术期指标、术后并发症发生率、手术疗效、总费用、日常生活功能恢复量表（functional recovery scale,FRS）评分、成本效果比（cost-effectiveness ratio,CER）、手术前后髋关节活动度评分、免疫炎性指标［白细胞介素6（interleukin-6,IL-6）、肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）、白细胞介素1β（interleukin-1β,IL-1β）］及凝血-纤溶系统指标［白陶土部分凝血活酶时间（kaolin partial thromboplastin time,KPTT）、凝血酶原时间（prothrombin time,PT）、组织型纤溶酶原激活物抑制剂（plasminogen activator inhibitor,PAI）、D二聚体（D-Dimer,D-D）］。 结果 THA组手术时间、术中出血量、住院时间长于或多于HA组（P＜0.05）;2组髋关节活动度评分均呈升高趋势,THA组髋关节活动度评分均高于HA组,组间、时点间、组间·时点间交互作用差异有统计学意义（P＜0.05）;THA组手术优良率高于HA组,术后并发症发生率低于HA组（P＜0.05）;2组IL-6、TNF-α、IL-1β、KPTT、PT、PAI、D-D水平均呈先升高后降低趋势,THA组IL-6、TNF-α、IL-1β、KPTT、PT、PAI、D-D水平高于HA组,组间、时点间、组间·时点间交互作用差异有统计学意义（P＜0.05）;THA组总费用和2年内CER高于HA组（P＜0.05）。2组FRS评分差异无统计学意义（P＞0.05）。 结论 与HA相比,THA治疗移位性股骨颈骨折患者虽然手术创伤较大,总体费用较高,但患者髋部功能改善更加明显,若患者年龄、预期寿命、身体情况及经济条件允许,建议行THA治疗。     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on early postoperative gait restoration in patients undergoing total hip arthroplasty （THA）. Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads （conventional group） and for 12 THAs （BHR group） using metal-on-metal femoral heads with an average size of 45 mm （range, 40-49mm）. All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length （SL）, single limb support （SLS）, cycle duration （CD）, and swing power （SP）. Harris Hip Scores and gait analysis parameters for both groups were compared. Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harristm postop - HarriSpreop and Harris3m postop- HarriSpreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal - SLaffected, （SLSnormal - SLSaffected）/CD, and SPnormal - SPaffected in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected, （SLSnormal- SLSaffected）/CD, and SPnormal - SPaffected were not significant, but the mean of SPnorrnal - SPaffected in the BHR group was significantly lower than that in the conventional group. Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.