Decreasing muscle strength is very common in the elderly population, leading to the risk of dislocation after hip arthroplasty. The purpose of this prospective cohort study was to determine the effects of biomimetic artificial hip arthroplasty combined with the modified Hardinge approach on safety, functional rehabilitation, and prognostic activity of daily living (ADL) in the elderly patients with decreasing muscle strength. Indicators included the Lovett muscle strength grading of the hip joint, hip range of motion (ROM), Harris score of hip joint function, and Barthel ADL score for the prognosis. The results showed that there were no differences in hip ROMs between the affected side and contralateral side from the discharging day, to 3 months, to 6 months after surgery, that there were no differences in the Harris scores, muscle strengths, and Barthel ADL scores between the affected side and pre-injury/contralateral side from 3 to 6 months after surgery, and that all of the patients did not experience postoperative dislocation during the follow-up. It suggests that the biomimetic hip arthroplasty combined with the modified Hardinge approach has the effects of promoting early rehabilitation, ensuring normal ROM, while avoiding the postoperative dislocation in elderly patients with decreasing muscle strength, and that patients can restore the pre-injury hip function and ADL within 3 months in post-operation.
XU Chang
,
YU Shouye
,
MA Diandong
,
ZHANG Bo
,
TANG Zibin
. On biomimetic artificial hip arthroplasty combined with modified operation approach for elderly patients with reduced muscle strength[J]. Science & Technology Review, 2023
, 41(23)
: 56
-63
.
DOI: 10.3981/j.issn.1000-7857.2023.23.008
[1] 陈良慈 . 核心稳定训练对骨质疏松症患者平衡功能、下肢肌力及跌倒发生的影响[J]. 临床研究, 2019, 27(3): 15-17.
[2] 李佳, 刘勃, 董天华, 等. 2010—2011年我国西南地区11所医院 60岁以上股骨颈骨折患者的流行病学特征分析[J]. 中华老年骨科与康复电子杂志, 2017, 3(2): 116-119.
[3] 王满宜, 危杰 . 股骨颈骨折临床研究的若干问题与新概念[J]. 中华创伤骨科杂志, 2003, 5(1): 5-9.
[4] Wang L, Yu W, Yin X, et al. Prevalence of osteoporosis and fracture in China: The China osteoporosis prevalence study[J]. JAMA Network Open, 2021, 4(8): e2121106.
[5] 贺丽英, 孙蕴, 要文娟, 等. 2010—2016年中国老年人骨质疏松症患病率Meta分析[J]. 中国骨质疏松杂志, 2016, 22(12): 1590-1596.
[6] Cornell C N. Guest editorial: An appeal for evidenced-based care and adoption of best practices in the management of displaced femoral neck fractures[J]. Clinic Orthopaedics and Related Research, 2019, 477(5): 913-916.
[7] Ullmark G. The unstable total hip arthroplasty[J]. EFORT Open Reviews, 2016, 1(4): 83-88.
[8] Philippot R, Camilleri J P, Boyer B, et al. The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: Analysis of 384 cases at a mean follow-up of 15 years[J]. International Orthopaedics, 2008, 33(4): 927-932.
[9] Boyer B, Philippot R, Geringer J, et al. Primary total hip arthroplasty with dual mobility socket to prevent dislocation: A 22-year follow-up of 240 hips[J]. International Orthopaedics, 2012, 36(3): 511-518.
[10] Guyen O, Chen Q S, Bejui-Hugues J, et al. Unconstrained tripolar hip implants: Effect on hip stability[J]. Clinic Orthopaedics and Related Research, 2007, 455: 202-208.
[11] 胡艳群, 李斌, 王蛟颜, 等 . 短期虚拟现实康复训练联合认知干预对老年脑卒中偏瘫患者运动功能、Lovett肌力分级及生存质量的影响分析[J]. 中国医学前沿杂志(电子版), 2018, 10(8): 97-101.
[12] 余小燕, 刘洋, 谷晓慧, 等 . 针刺麻醉与镇痛泵在肩关节术后镇痛领域中的应用及评价[J]. 科技导报, 2023, 41(3): 44-50.
[13] 邬黎平, 黄远翘, 陈元庄, 等 . 第三代 Serf 仿生双动全髋置换与普通全髋置换在高脱位风险患者中的随机对照研究[J]. 中华骨与关节外科杂志, 2020, 13(5): 396-401.
[14] Jasty M J, Floyd W E, Schiller A L, et al. Localized osteolysis in stable, non-septic total hip replacement[J]. The Journal of Bone Joint Surgery. American Volume, 1986, 68(6): 912-919.
[15] 石慧生, 张磊, 刘晓华. 关节镜下带线锚钉修复髋臼盂唇损伤的临床疗效[J]. 科技导报, 2020, 38(6): 78-82.
[16] 黄志环, 张丽莉, 范玉荣. Barthel指数指导下角色履职活动模式对脑梗死患者肢体功能及生活质量影响分析[J]. 中国医学创新, 2022, 19(10): 109-114.
[17] 张媛, 史凌云, 贾雪原, 等 . 老年髋部脆性骨折患者衰弱现状及影响因素分析[J]. 护理学报, 2020, 27(17):
24-29.
[18] Lutonsky M, Valis M, Srot J. Total hip arthroplasty after femoral neck fracture in patients with acquired neurological deficit[J]. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 2009, 76(3): 239-242.
[19] Ko L M, Hozack W J. The dual mobility cup: What problems does it solve[J]. The Bone & Joint Journal, 2016, 98-B(1 Suppl A): 60-63.
[20] Mohammed R, Hayward K, Mulay S, et al. Outcomes of dualmobility acetabular cup for instability in primary and revision total hip arthroplasty[J]. Journal of Orthopaedics and Traumatology, 2015, 16(1): 9-13.
[21] Coventry M B. Late dislocations in patients with Charnley total hip arthroplasty[J]. The Journal of Bone Joint Surgery. American Volume, 1985, 67(6): 832-841.
[22] Biedermann R, Tonin A, Krismer M, et al. Reducing the risk of dislocation after total hip arthroplasty: The effect of orientation of the acetabular component[J]. The Journal of Bone Joint Surgery. British Volume, 2005, 87(6): 762-729.
[23] Bernasek T L, Thatimatla N K, Levering M, et al. Effect of immediate full weight bearing on abductor repair and clinical function after THA through a modified Hardinge approach[J]. Orthopedics, 2013, 36(3): e266-270.
[24] McGrory B J, Harris W H. Can the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index be used to evaluate different hip joints in the same patient[J]. Journal of Arthroplasty, 1996, 11(7): 841-844.
[25] Soderman P, Malchau H. Is the Harris Hip Score system useful to study the outcome of total hip replacement[J] Clinic Orthopaedics and Related Research, 2001(384): 189-197.
