CAJ | 학술논문

目的：研究在伴有强直性骨盆倾斜的全髋关节置换术中，患肢长度对下腰部及髋关节功能的初期影响。方法自2005年1月至2010年3月，本组采用全髋关节置换术治疗伴有强直性骨盆倾斜的股骨头无菌性坏死24例，测量术前术后骨盆倾斜角和患肢延长的长度，并采用视觉模拟评分法（VAS）对下腰部和髋关节疼痛进行评分，Oswestry功能障碍指数（ODI）评估下腰部功能， Harris髋关节评分标准评估髋关节功能。结果所有患者均在术后1年接受随访评估，手术前后骨盆倾斜角无统计学差异。术后下腰部VAS疼痛评分和ODI与术前比较均有统计学差异（ P＜0.01），且VAS分值和ODI均与下肢延长长度呈正相关（ P＜0.01）。术后患髋VAS疼痛评分，与术前比较有统计学差异（P＜0.05）；手术前后的Harris评分有统计学差异（P＜0.01）。术后患髋VAS分值与下肢延长长度呈正相关（ F＝0．560，P＜0.01）；但术后Harris评分与下肢延长长度无统计学差异（ F＝0．072，P＞0.05）。结论在伴有强直性骨盆倾斜的全髋关节置换术中，保持患肢现有长度，既有利于髋关节初期功能的改善，也有利于提高下腰部和患侧髋关节的满意度。
목적：연구재반유강직성골분경사적전관관절치환술중，환지장도대하요부급관관절공능적초기영향。방법자2005년1월지2010년3월，본조채용전관관절치환술치료반유강직성골분경사적고골두무균성배사24례，측량술전술후골분경사각화환지연장적장도，병채용시각모의평분법（VAS）대하요부화관관절동통진행평분，Oswestry공능장애지수（ODI）평고하요부공능， Harris관관절평분표준평고관관절공능。결과소유환자균재술후1년접수수방평고，수술전후골분경사각무통계학차이。술후하요부VAS동통평분화ODI여술전비교균유통계학차이（ P＜0.01），차VAS분치화ODI균여하지연장장도정정상관（ P＜0.01）。술후환관VAS동통평분，여술전비교유통계학차이（P＜0.05）；수술전후적Harris평분유통계학차이（P＜0.01）。술후환관VAS분치여하지연장장도정정상관（ F＝0．560，P＜0.01）；단술후Harris평분여하지연장장도무통계학차이（ F＝0．072，P＞0.05）。결론재반유강직성골분경사적전관관절치환술중，보지환지현유장도，기유리우관관절초기공능적개선，야유리우제고하요부화환측관관절적만의도。
Objective To analyze the short-term influences of leg length inequality on the therapeutic efficacy of total hip arthroplasty ( THA) for the patients with stiff pelvic obliquity.Methods From January 2005 to March 2010, 24 patients with stiff pelvic obliquity underwent THA.The leg length and angles of pelvic obliquity were measured before and after the operation.The lower lumbar function was evaluated using visual analogue scales ( VAS ) and Oswestry disability index, and the hip function was evaluated using VAS and hip Harris function scores.Results All patients were followed up for one year after the operation. No significant difference was found in the postoperative pelvic obliquity angles comparing with the preoperative ones.There were significant differences in the VAS score and ODI of lower lumbar between the pre-operation data and the post-operation data (P<0.01 and P<0.01);the VAS and ODI were positively correlated with the leg length ( P<0.01 ) .There were significant differences in hip VAS score and Harris score between the pre-operative data and the post-operative data ( P<0.05 and P<0.01).The hip VAS score was positively correlated with leg length (P <0.01), but there was no correlation between Harris score and the leg length (P>0.05).Conclusion Maintaining the leg length in THA for the patients with stiff pelvic obliquity was beneficial to improving the hip function and the satisfaction for the functions of lower lumbar and hip.