全髋关节置换术的软组织平衡

目的探讨THA术后股骨偏心距恢复的重要性及重建方法,恢复髋关节的软组织平衡。方法对73例单侧THA术患者进行随访,手术均采用髋关节后外侧入路。X线片上测量股骨偏心距及髋外展肌的力臂,使用Cybex测量髋外展肌力量,对X线片测量数据进行统计学处理。结果股骨偏心距是否能够重建与髋最大外展肌肌力存在显著性差别(t=3.859;P=0.002);髋关节外展活动范围与股骨偏心距存在明显回归相关关系(r=0.593,P<0.001)。结论THA术中重建股骨偏心距可以增加髋外展肌的力臂,改善髋外展肌的力量,增强髋关节的稳定性。术中应选用近似解剖颈干角的股骨柄假体,适当地增加假体颈的长度。

Soft tissue balancing in total hip arthroplasty

Objective:To emphasize the importance and methods of restoring femoral offset during total hip arthroplasty(THA).Soft tissue balancing of the hip was reconstructed.Method:Seventy-three patients undergone unilateral THA were evaluated. A posterolateral approach was used in this series.The femoral offset and the abductor lever arm were measured from each radiograph. The measurement of the hip abduction strength was made for some THA by the Cybex machine. Statistical data analysis was performed using SPSS10.0 software.Result:Simple regression analysis showed that femoral offset was significantly and positively related to range of hip abduction (r=0.593,P<0.001). There was a highly significant positive correlation between femoral offset and hip abductor strength (t=3.859;P=0.002).Conclusion:It is very important to restore femoral offset in THA.This can increase the abductor lever arm and improve hip abductor strength to get soft tissue balancing and hip stability.Femoral component with more anatomical neck-shaft angle will be used with the increase in the femoral neck length.