Risk factors for revision total hip arthroplasty: emphasis on the characteristics of Japanese lifestyle
Risk factors for revision total hip arthroplasty: emphasis on the characteristics of Japanese lifestyle
复制标题
DOI：
10.1007/s00402-009-0906-9
复制
发表时间：
2009-12-01
影响因子：
2.3
通讯作者：
Masuhara, Kensaku
中科院分区：
文献类型：
--
作者：
Satoh, Masae;Kawaguchi, Takayasu;Masuhara, Kensaku
全髋关节置换术(THA)是提高退行性或创伤性髋关节病患者生活质量的常用技术。然而，总有需要修订的风险。本研究旨在通过分析THA翻修术的危险因素，制定生活质量评估和患者教育指南。对136例THA患者(翻修组：52例，非翻修组：84例)进行了自填式问卷调查。采用Logistic回归分析进行全髋关节置换术的危险因素分析，采用McNemar‘s检验比较两组患者手术前后生活姿势的变化，通过Logistic回归分析筛选出影响术后翻修的危险因素：初次全髋关节置换术后脱位(OR：10.5；95%CI：1.0~106.7)、生活用具提前准备不足(OR：5.0；95%CI：1.6~15.8)、如厕姿势不鼓励(OR：11.3；95%CI：1.1~115.9)。在术后期间，无翻修组在进食、如厕、洗澡、睡觉和休息时推荐体位的比例明显高于未翻修组(P<；0.001)。结果表明，推荐的生活姿势、提前准备生活用具和全髋关节置换术后预防脱位是评估全髋关节翻修术风险的有效指标，同时强调了日本生活方式中需要相当大髋关节活动度的方面。
Total hip arthroplasty (THA) is a common technique for increasing quality of life (QOL) in patients with degenerative or traumatic hip arthropathy. However, there is always a risk of THA requiring revision. The present study aimed to develop guidelines for QOL assessment and patient education by analyzing the risk factors for revision THA.In 136 patients who underwent THA (revision group: n = 52 and no revision group: n = 84), a self-administered questionnaire survey was conducted. Logistic regression analysis was used to investigate the risk factors for THA, and McNemar's test was used to compare the changes in living postures before and after surgery between the two groups.The following risk factors for revision were extracted by logistic regression analysis: dislocation after primary THA (OR: 10.5; 95% CI: 1.0-106.7), insufficient advance preparation of living aids (OR: 5.0; 95% CI: 1.6-15.8), and discouraged toileting postures (OR: 11.3; 95% CI: 1.1-115.9). In the postoperative period, the proportion of recommended postures while eating, toileting, bathing, sleeping, and resting was significantly higher for the no revision group (P < 0.001).The results suggest that recommended living postures, advance preparation of living aids, and dislocation prevention after THA are efficient indicators for assessing the risk for revision THA while emphasizing aspects of the Japanese lifestyle that require considerable hip joint range of motion.