CAJ | 학술논문

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。
목적：탐토전관관절치환술후하지불등장대관관절공능회복적영향。방법선취2008년2월지2012년10월재아원행전관관절치환수술적환자60례。술후측량쌍하지장도차，이환지연장1~10 mm자작위연장A조(n=24)，이환지연장11~20 mm자작위연장B조(n=18)，환지축단자작위축단조(n=8)，쌍하지등장자작위등장조(n=10)；수방1년，채용Harris관관절공능평분(HHS)평고각조환자술후3개월화1년시관관절공능。결과(1)술후3개월HHS평분：연장A조여연장B조지간비교차이무통계학의의(P>0.05)；연장량조명현저우축단조화등장조，차이구유통계학의의(P<0.05)；축단조화등장조비교차이무통계학의의(P>0.05)；(2)술후1년HHS평분：연장B조명현저우연장A조、축단조화등장조，차이구유통계학의의(P<0.05)；연장A조、축단조화등장조비교차이무통계학의의(P>0.05)；（3）연장A조술후1년HHS평분교술후3개월평분명현개선，차이구유통계학의의(P>0.05)；연장B조、축단조、등장조술후1년평분화술후3개월평분차이무통계학의의(P>0.05)。결론전관관절치환술후환지연장초과10 mm자대관절공능영향교대，이차불회수착시간연장이감경。
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 February 2008 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 ex-tension 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 signifi-cance (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.