CAJ | 학술논문

目的：探讨人工全髋关节置换术(THA)后双下肢不等长对患者髋关节功能和步态的影响。方法选取2011年2月至2013年2月初次行单侧THA的患者120例。术后测量双下肢长度，其中双下肢等长者32例(对照组)，患肢延长l~10 mm者56例(观察组1)，延长11~20 mm者32例(观察组2)。随访6个月，采用髋关节功能Harris评分(HHS)评价患者术后髋关节功能和步态。结果(1)髋关节HHS评分：随访结束时，观察组1和对照组之间的HHS评分比较差异无统计学意义(P>0.05)，观察组2的HHS评分明显低于对照组和观察组1，差异有统计学意义(P<0.05)；(2)步态分析：在步频、单腿支撑时间以及单腿支撑相占步态周期的百分比(Foot off)方面，观察组1和观察组2之间比较差异均无统计学意义(P>0.05)，而对照组则明显优于观察组1和观察组2，差异均具有统计学意义(P<0.05)。结论 THA术后患肢延长会对患者行走步态产生一定的影响，超过1 cm时会对髋关节功能造成影响。
목적：탐토인공전관관절치환술(THA)후쌍하지불등장대환자관관절공능화보태적영향。방법선취2011년2월지2013년2월초차행단측THA적환자120례。술후측량쌍하지장도，기중쌍하지등장자32례(대조조)，환지연장l~10 mm자56례(관찰조1)，연장11~20 mm자32례(관찰조2)。수방6개월，채용관관절공능Harris평분(HHS)평개환자술후관관절공능화보태。결과(1)관관절HHS평분：수방결속시，관찰조1화대조조지간적HHS평분비교차이무통계학의의(P>0.05)，관찰조2적HHS평분명현저우대조조화관찰조1，차이유통계학의의(P<0.05)；(2)보태분석：재보빈、단퇴지탱시간이급단퇴지탱상점보태주기적백분비(Foot off)방면，관찰조1화관찰조2지간비교차이균무통계학의의(P>0.05)，이대조조칙명현우우관찰조1화관찰조2，차이균구유통계학의의(P<0.05)。결론 THA술후환지연장회대환자행주보태산생일정적영향，초과1 cm시회대관관절공능조성영향。
Objective To investigate the impact of leg length discrepancy on function and gait of patients after total hip arthroplasty. Methods One hundred and twenty patients who proceed the first unilateral total hip ar-throplasty (THA) from February 2011 to February 2013 were selected. The length of leg after the surgery was mea-sured. There were 32 patients with equal leg length (control group), 56 patients with leg extension of l~10 mm (ob-servation group 1), and 32 patients with leg extension of 11~20 mm (observation group 2). The patients were fol-lowed up for 6 months, and Harris hip function score (HHS) was used to evaluate the postoperative hip function and gait. Results (1) HHS score:at the end of the follow-up, HHS score between observation group 1 and the con-trol group had no significant difference (P>0.05), HHS score of observation group 2 was significantly lower than that of the control group and observation group 1 (t=2.78, P<0.05). (2) Gait analysis:In frequency, single leg sup-port and time, the percentage of single leg support phase of gait cycle (Foot off), there was no significant difference between the observation group 1 and group 2 (P>0.05), and those indexes in the control group were significantly better than those in the observation group 1 and group 2 (P<0.05). Conclusion Leg extension after THA will pro-duce certain influence on the walking gait, which will affect the hip joint function when the extension is more than 1 cm.