True or Apparent Leg Length Discrepancy: Which Is a Better Predictor of Short-term Functional Outcomes After Total Hip Arthroplasty?
True or Apparent Leg Length Discrepancy: Which Is a Better Predictor of Short-term Functional Outcomes After Total Hip Arthroplasty?
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真实或明显的腿长差异：哪个是全髋关节置换术后短期功能结果的更好预测指标？
DOI：
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发表时间：
2013
影响因子：
2.4
通讯作者：
S. Izumi
中科院分区：
文献类型：
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作者：
Tatsuya Nakanowatari;Y. Suzukamo;T. Suga;Akira Okii;G. Fujii;S. Izumi
背景和目的：文献中尚不清楚全髋关节置换术(THA)后腿长差(LLD)与患者感觉的不平等和功能结果之间的关系。本研究的目的是确定全髋关节置换术后LLD的类型，并确定患者感知的LLD和全髋关节置换术后短期功能结果的最佳预测因子。方法：我们将LLD细分为真性型和表现型，并前瞻性地研究了53例接受单侧原发性全髋关节置换术的患者，以确定LLD的类型与术后2个月的功能结果之间是否存在关联。表观LLD用块试验测量，真LLD用髋关节X线片测量。我们将患者分为4组：真实组、显性组、混合组和非LLD组。调查问卷包括疼痛的视觉模拟评分，安大略省西部大学和麦克马斯特大学的骨关节炎指数，以及患者感知的不平等。体能表现通过步行速度和计时起跑测试来衡量。结果：明显LLD组和混合型LLD组患者感知不平等的发生率高于真实LLD组和非LLD组。体能测试结果显示，混合型LLD组的步行速度和表观LLD组的计时起跑测试结果均明显慢于真LLD组。讨论：我们认为，真正的LLD组可能与全髋关节置换术后的功能结果有微弱的关系，而髋关节痉挛或脊柱侧弯导致的骨盆倾斜导致的明显LLD与全髋关节置换术后的短期功能结果相关。结论：表观LLD可以比真实LLD更好地预测患者感知的不平等和体能表现。
Background and Purpose:The associations between leg length discrepancy (LLD) and patient-perceived inequality and functional outcomes after total hip arthroplasty (THA) are unclear in the literature. The aim of this study was to determine the types of LLD after THA and to identify the best predictor of patient-perceived LLD and functional outcome in the short term after THA. Methods:We subdivided LLD into true and apparent types and prospectively studied 53 consecutive patients undergoing unilateral primary THA to determine whether there is an association between the type of LLD and functional outcome 2 months after the operation. Apparent LLD was measured by the block test and true LLD was measured by hip radiography. We classified the patients into 4 groups: true, apparent, mixed, and no-LLD groups. The questionnaire included a visual analog scale of pain, the Western Ontario and McMaster Universities Osteoarthritis Index, and patient-perceived inequality. Physical performance was measured using walking speed and the Timed Up and Go test. Results:The apparent and mixed LLD groups had a higher prevalence of patient-perceived inequality than the true and no-LLD groups. The results of physical performance showed that the walking speed of the mixed LLD group and the results of the Timed Up and Go Test of the apparent LLD group were significantly slower than those of the true LLD group. Discussion:We suggested that the true LLD group may have a weak relationship with functional outcome after THA while the apparent LLD resulting from pelvic obliquity due to hip contracture or scoliosis is correlated with the short-term functional outcome after THA. Conclusion:Apparent LLD can be a better predictor of patient-perceived inequality and physical performance than true LLD.