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Crowe Ⅲ-Ⅳ型DDH患者全髋关节置换术后不满意及相关因素分析OACSTPCDMEDLINE

Analysis of dissatisfaction and related factors following total hip arthroplasty in patients with Crowe type Ⅲ-Ⅳ de-velopmental dysplasia of the hip

中文摘要英文摘要

目的:探讨全髋关节置换术的Crowe Ⅲ-Ⅳ型发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患者的满意度及造成不满意的相关因素.方法:回顾性分析2013年3月至2018年3月行全髋关节置换术的169例Crowe Ⅲ-Ⅳ型DDH患者,通过微信进行调查问卷,调查患者对手术总体满意度、10项日常功能满意度和患者认为对自己日常生活影响比较大的前5个问题.手术前后采用髋关节Harris评分进行功能评价.结果:收到完整调查问卷145份,所有患者获随访,时间1~5(3.23±1.22)年.145例患者分成两组,其中对手术疗效满意的118例,不满意的27例,手术总体满意率81.38%(118/145).患者认为对生活影响比较大的前5个问题分别是术后髋部疼痛,肢体明显不等长、行走、上下楼梯、蹲起.两组术前Harris评分比较,差异无统计学意义(P>0.05),不满意组术后Harris评分较低.术后髋关节疼痛、肢体不等长是影响手术不满意的直接因素.结论:采用全髋关节置换术治疗CroweⅢ-Ⅳ型DDH患者手术难度大;术后髋关节疼痛(轻度以上),肢体不等长(>2 cm)是术后不满意的独立危险因素.

Objective To investigate the satisfaction of patients with Crowe Ⅲ-Ⅳ developmental dysplasia of the hip(DDH)after total hip arthroplasty and the related factors.Methods A retrospective study included 169 patients with Crowe type Ⅲ-Ⅳ DDH who underwent total hip arthroplasty between March 2013 and March 2018.Patients were surveyed through WeChat,covering overall satisfaction with the operation,satisfaction with ten daily functions,and the top five questions per-ceived to have a great impact on daily life.Preoperative and postoperative hip function was evaluated by Harris score.Results One hundred and forty-five questionnaires were received,with a follow-up period ranging from 1 to 5 years with an average of(3.23±1.22)years.Among these patients,118 patients were satisfied with the surgical outcomes,while 27 patients were dissat-isfied,with the overall satisfaction rate of 81.38%(118/145).The top five problems affecting patient life were postoperative hip pain,limb length discrepancy,walking,stair climbing,and squatting.There were no statistical differences in age,sex,body mass index,preoperative Harris scores(P>0.05).However,the dissatisfied group had lower postoperative Harris scores.Post-operative hip pain and limb length discrepancy were identified as direct factors contributing to postoperative surgical dissatis-faction.Conclusion Total hip arthroplasty for patients with Crowe type Ⅲ-Ⅳ DDH is challenging.Postoperative hip pain(mild or severe)and limb length discrepancy(>2 cm)are independent risk factors for postoperative dissatisfaction.

赵鹏;李玉军;窦勇;王达成

北京大学第三医院延庆医院北京市延庆区医院骨科,北京 102100北京积水潭医院矫形科,北京 100035

临床医学

高脱位髋关节发育不良Crowe Ⅲ-Ⅳ全髋关节置换满意度

High dislocatedDevelopmental dysplasia of the hipCrowe Ⅲ-ⅣTotal hip arthroplsatySatisfaction

《中国骨伤》 2024 (004)

363-367 / 5

10.12200/j.issn.1003-0034.20220746

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