低侵襲人工股関節全置換術前後の下肢荷重バランス評価

抄録

Objective: We studied the weight-bearing balance of hip arthrosis patients before and after mini-mally invasive total hip arthroplasty to evaluate the recovery of standing and walking ability.
Methods: Thirty-eight patients who had primary total hip arthroplasties due to hip arthroses were studied. There were 5 males and 33 females. The average age was 62 years old at surgery. The average pre-operative JOA score was 48 points. Twenty-one patients were operated on by an anterior ap-proach method, and 17 were by a posterior approach method. Ten contralateral hip joints had osteoarthroses and 5 were converted to total hip arthroplasties. We studied the period in hospital, Trendelenburg sign, standing ability by single leg for 5 seconds and weight bearing balance, before surgery and at the time of leaving hospital. The weight bearing balance was measured in standing and in walking on the spot for 30 seconds by Anima gravicorder GS31P.
Results: The average period in hospital was 29 days. Six patients were in hospital over 30 days, 4 because of complications, which were ileitis, hip dislocation, pulmonary infarction and implant subsidence. Trendelenburg-sign patients decreased from 31 before surgery to 11 at the time of leaving hospital. The number of patients who could not stand on one leg for 5 seconds decreased from 22 before surgery to 4 at leaving hospital. Weight-bearing of the operated leg in standing was 48.7% of the body weight before surgery and 45.8% at leaving hospital. And that in stepping on the spot was 47.6% before surgery and 47.0% at leaving hospital. There was no significant decrease at leaving hospital. There was a correlation between the weight-bearing balance's in walking on the spot before and after surgery.
Conclusion: The study of weight bearing of total hip arthroplasty patients revealed that clinical standing ability signs improved and the weight-bearing balance recovered to the pre-surgery level at leaving hospital.