Rapid Return to Braking After Anterior and Posterior Approach Total Hip Arthroplasty.

John T Richards, Sean E Slaven, Bobby G Yow, Robert W Tracey, Andrew W Mack, John P Cody
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Abstract

Background: Little is known about the effect of surgical approach on return to braking after total hip arthroplasty (THA), and few studies have investigated braking after THA with modern surgical techniques and rehabilitation protocols.

Methods: In a prospective comparative design, we enrolled 65 patients who received right-sided primary THA at our institution from April 2018 through March 2020, 34 with a direct anterior approach (DAA) and 31 with a posterior approach (PA). Braking tests measuring brake reaction time (BRT) and brake pedal depression (BPD) were administered to patients preoperatively and at 1, 2, and 4 weeks postoperatively using a realistic driving simulator. BRT and BPD were compared between groups and preoperatively versus postoperatively using mixed-effects models.

Results: Preoperative BRT averaged 638 msec in the DAA group and 604 msec in the PA group (P = 0.31). At 1 week postoperatively, the DAA group had significantly prolonged BRT compared with preoperatively (694 msec, P = 0.02). No significant difference was observed in the PA group (633 msec, P = 0.31). Both groups had returned to baseline by 2 weeks, and both had significantly faster BRT at 4 weeks compared with preoperatively (583 msec for DAA, P = 0.01; 537 msec for PA, P < 0.001). BPD was similar between groups, and there were no significant differences between preoperative and postoperative BPD at any time point.

Conclusions: With modern surgical techniques, BRT after right-sided THA returns to baseline levels approximately 2 weeks after surgery. There seems to be a quicker return to preoperative BRT observed in patients with a PA.

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前路和后路全髋关节置换术后快速恢复制动。
背景:人们对手术方式对全髋关节置换术(THA)后恢复制动的影响知之甚少,很少有研究调查了采用现代手术技术和康复方案进行THA后的制动情况:在前瞻性比较设计中,我们纳入了 2018 年 4 月至 2020 年 3 月期间在我院接受右侧初次 THA 的 65 例患者,其中 34 例采用直接前路(DAA),31 例采用后路(PA)。在术前、术后 1 周、2 周和 4 周,使用逼真的驾驶模拟器对患者进行了制动测试,测量制动反应时间(BRT)和制动踏板压陷(BPD)。使用混合效应模型对各组之间以及术前与术后的制动反应时间和制动踏板抑制进行比较:结果:DAA 组术前 BRT 平均为 638 毫秒,PA 组为 604 毫秒(P = 0.31)。术后 1 周,DAA 组的 BRT 与术前相比明显延长(694 毫秒,P = 0.02)。PA 组则无明显差异(633 毫秒,P = 0.31)。两组患者在 2 周时均已恢复至基线,4 周时的 BRT 与术前相比均明显加快(DAA 组为 583 毫秒,P = 0.01;PA 组为 537 毫秒,P < 0.001)。各组间的BPD相似,术前和术后任何时间点的BPD均无明显差异:结论:采用现代手术技术,右侧 THA 术后 BRT 可在术后 2 周左右恢复到基线水平。结论:采用现代手术技术,右侧 THA 术后 BRT 在术后 2 周左右恢复到基线水平,PA 患者的 BRT 似乎恢复得更快。
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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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