Effect of Preoperative Leg Length Discrepancy on Functional Outcome and Patient Satisfaction After Total Hip Arthroplasty in Cases of Osteonecrosis of the Femoral Head
Effect of Preoperative Leg Length Discrepancy on Functional Outcome and Patient Satisfaction After Total Hip Arthroplasty in Cases of Osteonecrosis of the Femoral Head
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DOI：
10.1016/j.arth.2016.05.039
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发表时间：
2016-12-01
影响因子：
3.5
通讯作者：
Qi, Xin
中科院分区：
文献类型：
--
作者：
Dong, Ning;Yang, Chen;Qi, Xin
背景资料：术前严重的下肢不等长（LLD）可导致广泛性股骨头坏死（ONFH）患者术前功能状态差。方法：将22例术前X线片显示重度LLD（>= 15 mm）和44例术前X线片显示轻度LLD（< 15 mm）的ONFH患者作为研究组和对照组。66例均为单侧股骨头坏死。患者的功能结局（Harris髋关节评分[HHS]、牛津髋关节评分[OHS]、患者感知LLD、视觉疼痛量表[VAS]疼痛评分和跛行评估）和满意度在THA术后3个月和12个月评价患者满意度（自我管理的患者满意度量表）。全髋关节置换术后3个月，研究组的HHS结局较差（P = 0.002）和OHS（P = .002），患者自认为的LLD患病率较高（P = 0.002），跛行（P <0.001）比对照组，但自我管理的患者满意度量表和VAS疼痛评分没有差异。然而，两组从术前评估到3个月的HHS和OHS改善相当。在THA术后12个月，功能结局或自我满意度没有显著差异，研究组从术前评估到12个月的改善明显更大（P < .05）。结论：在HHS和OHS方面，重度LLD患者在THA后3个月与轻度LLD患者的改善相似，但在术后12个月时改善更大。与轻度LLD患者相比，(C)2016 Elsevier Inc. All rights reserved.
Background: Severe preoperative leg length discrepancy (LLD) can lead to poor preoperative functional status in patients with extensive osteonecrosis of the femoral head (ONFH). This study aimed to assess the effect of preoperative LLD on functional outcomes and patient satisfaction post-total hip arthroplasty (THA) in ONFH patients.Methods: Twenty-two patients with severe LLD (>= 15 mm) and 44 patients with mild LLD (< 15 mm) on preoperative radiographs were enrolled as the study group and control group, respectively. All 66 patients were diagnosed with unilateral ONFH. Patients' functional outcomes (Harris Hip Score [HHS], Oxford Hip Score [OHS], patient-perceived LLD, Visual Analogue Scale [VAS] pain score, and Limping Assessment]) and satisfaction (self-administered patient satisfaction scale) were evaluated at 3 and 12 months after THA.Results: At 3 months after THA, the study group had poorer outcomes in terms of the HHS (P = .002) and OHS (P = .002), a higher prevalence of patient-perceived LLD (P = .002), and worse limping (P < .001) than the control group, but the self-administered patient satisfaction scale and VAS pain scores did not differ. However, improvements in the HHS and OHS from preoperative assessment to 3 months were comparable in both groups. At 12 months after THA, there were no significant differences in functional outcomes or self-satisfaction, and the study group showed significantly greater improvements from preoperative assessment to 12 months (P < .05).Conclusion: Patients with severe LLD experienced similar improvement at 3 months after THA as those with mild LLD in terms of the HHS and OHS but showed greater improvement at 12 months post-operatively than patients with mild LLD. (C) 2016 Elsevier Inc. All rights reserved.