Hip Muscle Torque in Patients with Total Hip Replacement: A Ten-Year Follow-Up Study

全人工髖關節置換患者髖關節力矩值之十年追蹤

詹美華(Mei-Hwa Jan) ； 林千禾(Chien-Ho Lin) ； 劉堂桂(Tang-Kue Liu)

《物理治療》 27卷3期 (2002/06) Pp. 111-118

摘要

背景與目的：人工髖關節置換對髖關節有嚴重病變的患者而言，已是高接受度的手術方式。已有文獻報告此類病患手術後二、三年內的肌力恢復情形。但國內外尚不見術後三年、五年、甚至更長久時間後與肌力相關的文獻報告。方法：本研究以完成10年追蹤的23位單側全人工髖關節置換患者為研究對象，以Cybex 350等速肌力測試儀測量其兩側髖關節等長力矩值。測試的肌肉包括髖伸肌、屈肌、內收肌及外展肌四肌群。測試方法完全依照Cybex等長肌力測試法測試。受試者術後滿六個月做第一次測試，滿一年做第二次測試，之後每年皆接受一次的髖關節力矩值測試至術後第十年。結果：術後第三年，肌力的恢復值達最高峰，而且兩側髖關節肌力皆有進步。開刀側肌群此時的力矩值是術後六個月值的124~174%，非開刀側力矩值也達同側術後六個月值的109~159%。此外，此時除髖外展肌外，其它所有髖關節肌群之開刀側力矩值皆已恢復到非開刀側值的百分之九十以上。髖外展肌是所有髖關節肌群中肌力恢復最慢且最少的；髖外展肌肌力恢復到第四年才到高峰，而且未達非開刀側值的90%。超過術後三、四年，受試者髖關節肌力即逐漸下降，但第五年到第十年之間，肌力的下降速率較慢。開刀側髖關節肌力的力矩值在術後第十年，幾乎都已降回到術後六個月時的數值，甚至更低。未開刀側髖關節肌力的力矩值則已全面比術後六個月時的力矩值差。結論：全人工髖關節置換患者術後髖關節肌力會明顯改善，但術後第四年之後又逐漸下降，術後第十年已降至首次評估值；術後第十年未開刀側髖關節肌力比開刀側差。

關鍵字

肌力矩 ； 全人工髖關節置換 ； 關節整型術 ； 髖關節

並列摘要

Purpose: This study was to investigate the isometric muscle torque of patients with primary total hip replacement (THR) by long-term follow-up. Methods: A prospective study was conducted to quantitatively measure the hip muscle torque in 23 patients with unilateral hip disorders following primary THR. Maximum isometric torque of the hip flexors, extensors, abductors and adductors were annually measured from the sixth month to the tenth year after THR using the Cybex 350 dynamometer. Results: The results showed improvement in the muscle strength of both operated and non-operated hips after THR. Furthermore, the most obvious improvement of muscle torque w as observed 3 years post-operation. Using the muscle torque measured 6 months post-operation at the samelimb as the reference, the improvement was 124-174% for the operated hip and 109-159% for the non-operated hip. Regarding muscle strengh, all of the operated hip muscles, except for the abductos, showed progress to over 90% of non-operated hip muscles. None of the muscles at the operated hip showed progress to the same level of muscle strength of the non-operated hip. Following three to four years after the operation, there was an obvious decline in muscle strength of the operated hips. Then, the muscle strength of the operated hip showed a steady decline from the 5th year to the tenth year after THR. Conclusion: Muscle strengthening exercises of bilateral hip joints are suggested to be prescribed to patients with THR, even if the muscle strength seem to have reached maximum recovery.

並列關鍵字

Muscle torque ； Hip joint replacement ； Arthroplasty ； Hip