Is There Faster Recovery With an Anterior or Anterolateral THA? A Pilot Study
Is There Faster Recovery With an Anterior or Anterolateral THA? A Pilot Study
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DOI：
10.1007/s11999-009-1075-4
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发表时间：
2010-02-01
影响因子：
4.2
通讯作者：
Chou, Li-Shan
中科院分区：
文献类型：
--
作者：
Klausmeier, Virginia;Lugade, Vipul;Chou, Li-Shan
手术技术是影响全髋关节置换术后髋关节功能恢复的重要因素。因此，我们询问前路和前外侧THA入路的髋关节强度和活动度的短期恢复是否不同。我们推测，尽管与术前相比，两种方法在术后16周时均能改善髋关节功能，但与前组相比，前外侧组在6周时恢复较慢，这是外展肌分离和重新附着的结果。观察患者行走时髋关节的运动学和动力学，以及患肢髋外展肌等长肌力。在所有三个测试时间，所有患者的髋关节外展肌强度均低于对照组。与术前相比，术后16周所有患者的外展肌力均得到改善。在6周时，前路手术的患者术后后期站立位外展肌峰力矩得到改善，达到对照组水平，但前外侧手术的患者没有改善。虽然前路手术与术前相比，6周时步态速度和峰值屈肌力矩改善相关，但我们观察到6周或16周时两种方法之间的大多数等长力量和动态步态测量值无差异。这两种方法都不能提供更快的恢复。
Surgical technique is an important factor affecting recovery of hip function after total hip arthroplasty (THA). We therefore asked whether short-term recovery of hip strength and motion would differ between the anterior and anterolateral THA approaches. We presumed that although both approaches would improve hip function by 16 weeks postsurgery when compared with presurgery, a slower recovery would be demonstrated by the anterolateral group at 6 weeks when compared with the anterior group as a result of division and reattachment of the abductor muscles. We observed hip kinematics and kinetics during walking and isometric hip abductor strength for the involved limb. Hip abductor strength of all patients was lower than controls at all three testing times. Compared with presurgery, all patients demonstrated improved abductor strength at 16 weeks postsurgery. At 6 weeks, the patients with an anterior approach had improved late stance peak abductor moment postsurgery and reached the level of controls, but those with an anterolateral approach did not. Although the anterior approach was associated with improved gait velocity and peak flexor moments at 6 weeks compared to before surgery, we observed no differences between the two approaches for most of the isometric strength and dynamic gait measures at 6 or 16 weeks. Neither approach provided faster recovery.