CAJ | 학술논문

背景：股骨偏心距的重建对于恢复外展肌力和髋关节周围软组织张力平衡，维持关节稳定，恢复关节功能，减少置换后跛行，降低假体磨损、人工关节脱位等并发症的发生率具有重要意义。 　　目的：探讨全髋置换的重建偏心距对髋关节功能恢复的影响。 　　方法：对比分析采用组配式假体(S-ROM)行全髋置换20例20髋患者及采用普通假体(Corail)行全髋置换19例20髋患者的相关资料，通过临床(Harris评分)和X射线测量，对两组患者置换后髋关节功能和偏心距重建率进行对比研究。 　　结果与结论：纳入患者均无感染、骨折、脱位，无深静脉血栓及神经损伤等并发症。临床随访：在组配式假体和普通假体两组中，股骨偏心距重建组与未重建组置换前Harris评分差异无显著性意义(P>0.05)；置换后12个月及末次随访偏心距重建患者Harris评分高于未重建者(P <0.05)。髋关节外展活动度大于未重建患者(P <0.05)。X射线随访：组配式假体和普通假体两组中股骨偏心距重建率差异有显著性意义(χ2=3.956，P<0.05)，39髋(98%)股骨假体位于中立位，1髋(2.5%)轻度外翻位，两组中股骨偏心距得到重建与未得到重建患者的髋臼假体外展角及前倾角差异均无显著性意义(P >0.05)。说明组配式假体和普通假体两组中股骨偏心距得到重建患者的髋关节功能和髋关节外展活动度优于未得到重建者，组配式假体偏心距重建率高。
배경：고골편심거적중건대우회복외전기력화관관절주위연조직장력평형，유지관절은정，회복관절공능，감소치환후파행，강저가체마손、인공관절탈위등병발증적발생솔구유중요의의。 　　목적：탐토전관치환적중건편심거대관관절공능회복적영향。 　　방법：대비분석채용조배식가체(S-ROM)행전관치환20례20관환자급채용보통가체(Corail)행전관치환19례20관환자적상관자료，통과림상(Harris평분)화X사선측량，대량조환자치환후관관절공능화편심거중건솔진행대비연구。 　　결과여결론：납입환자균무감염、골절、탈위，무심정맥혈전급신경손상등병발증。림상수방：재조배식가체화보통가체량조중，고골편심거중건조여미중건조치환전Harris평분차이무현저성의의(P>0.05)；치환후12개월급말차수방편심거중건환자Harris평분고우미중건자(P <0.05)。관관절외전활동도대우미중건환자(P <0.05)。X사선수방：조배식가체화보통가체량조중고골편심거중건솔차이유현저성의의(χ2=3.956，P<0.05)，39관(98%)고골가체위우중립위，1관(2.5%)경도외번위，량조중고골편심거득도중건여미득도중건환자적관구가체외전각급전경각차이균무현저성의의(P >0.05)。설명조배식가체화보통가체량조중고골편심거득도중건환자적관관절공능화관관절외전활동도우우미득도중건자，조배식가체편심거중건솔고。
BACKGROUND:Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation. OBJECTIVE:To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty. METHODS:We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied in both groups. RESULTS AND CONCLUSION:No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical fol ow-up results:In the modular prosthesis and one modular prosthesis groups, there was no significant difference in preoperative Harris hip score between the femoral offset reconstruction and non-reconstruction groups (P>0.05). At 12 months and the latest fol ow-up, the Harris hip score was higher in the patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). The range of abduction of hip joint was larger in patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). Radiographic fol ow-up results:significant differences in the rate of femoral offset reconstruction were detected between the modular prosthesis and one modular prosthesis groups (χ2=3.956, P<0.05). 39 (98%) femoral stems were in neutral position and one (2.5%) was in mild valgus. There was no significant difference in the abduction angle and the anteversion angle between patients with and without femoral offset reconstruction (P>0.05). These results indicated that functional recovery and the range of abduction were better in patients with femoral offset reconstruction than those without femoral offset reconstruction. Modular prosthesis has a high rate of femoral offset reconstruction.