全髋关节置换术后下肢不等长对髋关节功能恢复的影响

目的探讨全髋关节置换术后下肢不等长对髋关节功能恢复的影响。方法选取2008年2月至2012年10月在我院行全髋关节置换手术的患者60例。术后测量双下肢长度差,以患肢延长1~10 mm者作为延长A组（n=24）,以患肢延长11~20 mm者作为延长B组（n=18）,患肢缩短者作为缩短组（n=8）,双下肢等长者作为等长组（n=10）;随访1年,采用Harris髋关节功能评分（HHS）评估各组患者术后3个月和1年时髋关节功能。结果 （1）术后3个月HHS评分：延长A组与延长B组之间比较差异无统计学意义（P〉0.05）;延长两组明显低于缩短组和等长组,差异具有统计学意义（P〈0.05）;缩短组和等长组比较差异无统计学意义（P〉0.05）;（2）术后1年HHS评分：延长B组明显低于延长A组、缩短组和等长组,差异具有统计学意义（P〈0.05）;延长A组、缩短组和等长组比较差异无统计学意义（P〉0.05）;（3）延长A组术后1年HHS评分较术后3个月评分明显改善,差异具有统计学意义（P〉0.05）;延长B组、缩短组、等长组术后1年评分和术后3个月评分差异无统计学意义（P〉0.05）。结论全髋关节置换术后患肢延长超过10 mm者对关节功能影响较大,而且不会随着时间延长而减轻。

The influence of leg length discrepancy on functional recovery after total hip arthroplasty

Objective To explore the influence of leg length discrepancy on functional recovery after total hip arthroplasty. Methods Sixty patients with total hip arthroplasty in our hospital were collected from February2008 to October 2012. According to the length discrepancy of lower limbs, the patients were divided into 4 groups：group A of extension（leg extend 1~10 mm, n=24）, group B of extension（leg extend 11~20 mm, n=18）, shorten group（n=8）, and isometric group（leg equal length, n=10）. A1-year follow-up was carried out to value thehip joint function of those patients by using Harris hip function double score（HHS） method at two time points, 3 month and 1 year after operation. Results（1） When scored at 3 month after operation, the differences between group A and group B of extension had no statistical significance（P〉0.05）, two groups of extension were significantly lower than the shorten and isometric groups（P〈0.05）, and the differences between shorten group and isometric group has no statistical significance（P〉0.05）.（2） When scored at 1 year after operation, group B of extension was significantly lower than group A of extension, shorten group and isometric group（P〈0.05）, the differences between group A of extension, shorten group and isometric group had no statistical significance（P〉0.05）.（3） The HHS score of 1 year after operation was significantly higher than that of 3 month after operation（P〉0.05）. There were no statistically significant differences at HHS scores of both 3 month and 1 year after operation among group B of extension, shorten group and isometric group（P〉0.05）. Conclusion Leg length discrepancy of more than 10 mm affected functional recovery after total hip arthroplasty, which did not reduce with time extension.