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
Analysis of dissatisfaction and related factors following total hip arthroplasty in patients with Crowe type Ⅲ-Ⅳ de-velopmental dysplasia of the hip
赵鹏 1李玉军 2窦勇 2王达成2
作者信息
- 1. 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
- 2. 北京积水潭医院矫形科,北京 100035
- 折叠
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.
Abstract
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.
关键词
高脱位/髋关节发育不良/Crowe/Ⅲ-Ⅳ/全髋关节置换/满意度Key words
High dislocated/Developmental dysplasia of the hip/Crowe Ⅲ-Ⅳ/Total hip arthroplsaty/Satisfaction引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据