全髋关节置换术后骶髂关节疼痛:站立和坐姿下临床数据与三维成像的综合分析。

IF 2 3区 医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2024-10-01 Epub Date: 2024-08-20 DOI:10.1007/s00264-024-06270-w
Jean Yves Lazennec, Aidin Eslam Pour
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引用次数: 0

摘要

目的:全髋关节置换术(THA)后,患者经常抱怨腰痛和骶髂关节痛(SIP)。我们假设 SIP 患者在站立位和放松坐位时会显示不同的骨盆入射角 (PI),这表明骶髂关节的活动增加:在这项回顾性病例对照研究中,94 名接受过单侧 THA 并出现 SIP 的患者与 94 名未出现 SIP 的对照组患者进行了比较。SIP 通过临床测试确认,并使用站立和坐姿双平面成像进行调查。分析的主要参数包括PI、骶骨斜度(SS)、腰椎前凸(LL)和肢长差异(LLD):结果:没有 SIP 的患者从站姿到坐姿的 PI 平均相差-1.5°(-8°-5°),而有 SIP 的患者相差-3.3°(-12°-0°):本研究显示,THA术后SIP患者的骶髂关节运动明显,表现为PI变化、骨盆后倾增加和LL变化减少。与一般观点相反,SIP 与 LLD 并不相关。
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Sacroiliac pain after total hip arthroplasty: a combined analysis of clinical data and three-dimensional imaging in standing and sitting positions.

Purpose: Patients frequently complain of low back pain and sacroiliac joint pain (SIP) following total hip arthroplasty (THA). We hypothesized that patients with SIP would display different pelvic incidence (PI) values between standing and relaxed sitting positions, indicative of increased motion in the sacroiliac joints.

Methods: In this retrospective case-control study, 94 patients who underwent unilateral THA and experienced SIP were compared with 94 control patients without SIP. SIP was confirmed through clinical tests and investigated using biplanar imaging in both standing and sitting positions. The key parameters analyzed included PI, sacral slope (SS), lumbar lordosis (LL), and limb length discrepancy (LLD).

Results: Patients without SIP showed a mean difference in PI of -1.5° (-8°-5°) between standing-to-sitting positions, whereas those with SIP showed a difference of -3.3° (-12°-0°)(P < 0.0001), indicating more motion in the sacroiliac joint during daily activities in the latter group. Patients with SIP showed smaller change in LL between standing-to-sitting positions (mean:6.3°; range:-8°-27°) compared with those without SIP (mean:9.5°; range:-12°-28°)(P = 0.006). No significant differences were noted in functional leg length between patients with (mean:7 mm; range:0-12 mm) and without SIP (mean:7 mm; range:0-11 mm)(P = 0.973).

Conclusions: This study revealed significant sacroiliac joint motion in patients with SIP post-THA, as indicated by PI changes, increased posterior pelvic tilt, and reduced change in the LL. Contrary to common belief, SIP did not correlate with LLD.

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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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