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首页> 外文期刊>Journal of orthopaedic research >Does hip implant positioning affect the peak external adduction moments of the healthy knees of subjects with total hip replacements?
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Does hip implant positioning affect the peak external adduction moments of the healthy knees of subjects with total hip replacements?

机译：髋关节植入物的位置是否会影响全髋关节置换患者的健康膝盖的峰值内收瞬间？

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摘要

After unilateral total hip replacement (THR) for hip osteoarthritis (OA), knee OA incidence or progression is common. The contralateral knee is at particular risk, and some have speculated that abnormal THR-hip biomechanics contributes to this asymmetry. We investigated the relationships between operated-hip joint geometry or gait variables and the peak external knee adduction moments - an indicator of knee OA risk - in 21 subjects with unilateral THRs. We found that the peak adduction moment was 14% higher on the contralateral versus the ipsilateral knee (p = 0.131). The best predictors of ipsilateral knee adduction moments were superior-inferior joint center position and operated-hip peak adduction moment (adj R2 = 0.291, p = 0.017). The sole predictor of the contralateral knee adduction moment was the medial-lateral hip center position (adj R2 = 0.266, p = 0.010). A postoperative medial shift of the hip center was significantly correlated with a lower postoperative contralateral/ipsilateral knee adduction moment ratio (R = 0.462, p = 0.035). Based on these relationships, we concluded that implant positioning could influence the biomechanical risk of knee OA progression after THR. Although implant positioning decisions are necessarily driven by other factors, it may be appropriate to assess individual THR candidate's knee OA risk and adjust perioperative management accordingly.
机译：单侧全髋关节置换术（THR）治疗髋骨关节炎（OA）后，膝关节OA的发生或发展是常见的。对侧膝关节处于特别危险中，一些人推测异常的THR-hip生物力学会导致这种不对称。我们调查了21名单侧THR患者的手术髋关节几何形状或步态变量与峰值外部膝关节内收弯矩之间的关系（膝部OA风险的指标）。我们发现对侧膝关节的峰值内收力矩比同侧膝关节高14％（p = 0.131）。同侧膝关节内收力矩的最佳预测指标是上下关节中心位置和手术髋关节峰值内收力矩（adj R2 = 0.291，p = 0.017）。对侧膝关节内收力矩的唯一预测指标是内侧-外侧髋关节中心位置（adj R2 = 0.266，p = 0.010）。术后髋关节中心内侧移位与术后对侧/同侧膝关节内收力矩比降低显着相关（R = 0.462，p = 0.035）。基于这些关系，我们得出结论，植入物的位置可能会影响THR后膝骨OA进展的生物力学风险。尽管植入物的定位决定必定受其他因素影响，但评估个体THR候选人的膝OA风险并相应地调整围手术期管理可能是适当的。

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