摘要
背景:近年来腰椎与髋关节同时存在疾患并手术的患者增多,关于腰椎融合患者全髋关节置换后中期疗效的研究目前开展较少。目的:探讨腰椎融合对全髋关节置换患者置换后中期疗效的影响。方法:回顾性分析2014年1月至2019年1月在徐州医科大学附属医院接受初次全髋关节置换患者的临床和影像学资料,根据术前是否存在腰椎融合史将患者分为融合组和非融合组。融合组共41例,从同期全髋关节置换的患者中,按融合组性别、年龄、体质量指数±5、术前目测类比评分±2、术前Harris髋关节评分±10维持1∶2匹配,筛选出82例患者作为非融合组。比较两组患者术后末次随访时出现的并发症及Harris髋关节评分,再通过术前站立位和坐位间骨盆倾斜角变化(ΔPT),将融合组患者分为骨盆僵硬组(ΔPT<20°)和非骨盆僵硬组(ΔPT≥20°),比较两组患者的疗效差异。结果与结论:(1)所有患者均获得36个月以上的随访;融合组脱位风险高于非融合组,差异有显著性意义(P=0.035);(2)融合组在Harris髋关节评分中的活动评分(P=0.030)及总分(P=0.001)均低于非融合组;(3)骨盆僵硬组患者末次随访Harris髋关节评分显著低于非骨盆僵硬组(P=0.032);(4)提示腰椎融合患者行全髋关节置换的预后比一般全髋关节置换患者差,尤其是骨盆僵硬的患者;且腰椎融合患者全髋关节置换后的脱位风险相对较高;这为既往腰椎融合预行全髋关节置换的患者术前进行常规脊柱成像提供了支持,并给患者提供了术后期望值。
BACKGROUND:In recent years,the number of patients with simultaneous lumbar and hip joint diseases and undergoing surgery has increased.The mid-term prognosis of patients with lumbar fusion after total hip arthroplasty is rarely studied.OBJECTIVE:To investigate the mid-term effect of total hip arthroplasty in patients with lumbar fusion.METHODS:Clinical and imaging data of patients who received initial total hip arthroplasty at the Affiliated Hospital of Xuzhou Medical University from January 2014 to January 2019 were retrospectively analyzed.Patients were divided into a fusion group and a non-fusion group according to whether there was lumbar fusion before surgery.There were 41 patients in the fusion group.Among the patients with concurrent total hip arthroplasty,gender,age,body mass index±5,visual analog scale score±2,preoperative Harris hip score±10 maintained 1:2 matching,and 82 patients were selected as the non-fusion group.The complications and Harris hip score of the two groups at the last postoperative follow-up were compared,and the fusion group was divided into a pelvic stiffness group(ΔPT<20°)and a non-pelvic stiffness group(ΔPT≥20°)according to the changes of pelvic tilt angle(ΔPT)between standing and sitting positions before surgery.The difference in curative effect was compared between the two groups.RESULTS AND CONCLUSION:(1)All patients were followed up for more than 36 months.The rate of dislocation in the fusion group was higher than that in the non-fusion group(P=0.035).(2)The range of motion score(P=0.030)and total Harris hip score(P=0.001)in the fusion group were lower than those in the nonfusion group.(3)The Harris hip score of the patients of pelvic stiffness group at the last follow-up was significantly lower than that of the non-pelvic stiffness group(P=0.032).(4)It is concluded that the prognosis of patients with lumbar fusion after total hip arthroplasty was worse than that of patients with general total hip arthroplasty,especially those with pelvic stiffness.Moreover,patients
作者
郭卓涛
张凯
查国春
郭开今
Guo Zhuotao;Zhang Kai;Zha Guochun;Guo Kaijin(Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China;Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第36期5801-5805,共5页
Chinese Journal of Tissue Engineering Research
关键词
全髋关节置换
腰椎融合
骨盆僵硬
术后疗效
脱位
total hip arthroplasty
lumbar fusion
pelvic stiffness
postoperative efficacy
dislocation
