The Study On The Relationship Between Hip Abductor Abduction And Type C1 Femoral Head Acetabulum Based On The Theory Of Both Bones And Bones

ObjectiveIn the middle and late stage of osteonecrosis of the femoral head,the muscle weakness of the hip joint abducens often presents with claudication.The femoral head shift more outward,presenting subluxation in varying degrees.However,the state of femoral head necrosis with subluxation is not only in the late stage of femoral head necrosis,but it is already present in the initial stage of the disease in some patients who often have shorter time from diagnosis to collapse and have a poor prognosis.What the aim of this prospective study is to observe changes in hip imaging and abductor muscle strength by exercising hip abductor muscles,and to assess the effect of abductor muscle strength exercise on correcting subluxation,improving head-and-mouth relationship,and increasing the coverage of head lice.At the same time,we retrospectively studied previous cases and analyzed the importance of muscle strength of abductors.MethodsProspective study of hospitalized patients in the orthopedic region of the First Affiliated Hospital of Guangzhou University of Chinese Medicine between December 2016 and June 2017;retrospective comparison between January 2016 and March 2017 at Guangzhou University of Chinese Medicine Affiliated hospital orthopedics or inpatients.The affected sides of both groups were femoral head necrosis with subluxation,and the classification was classified as type C1 in the JIC classification.A prospective study(observation group)took hip muscle abductor muscle exercises combined with traditional Chinese medicine conservative treatment.Clinical retrospective analysis(control group)took only traditional Chinese medicine conservative treatment.By observing the change of the hip imaging parameters of the two groups(mainly including the hip medial clearance,hip medial clearance ratio,lateral deviation of the femoral head,steamed bread index,bone marrow edema);at the same time,the abductor muscles of the observation group were treated before and after treatment,Strength measurement,and self-analysis of abductor muscle strength and pain scores,Harris scores,iHOT-12 scores,SF-12 quality of life and other changes,and perform statistical analysis.ResultsA total of 30 patients were included in the prospective study and the retrospective control group each,including observation group:aged 25 to 64 years,average 40.70 ±8.74 years,weight 46.5 to 80 kg,average 60.79±9.17 kg;height 153 to 183 cm,average 167.53±7.61 cm;BMI 17.31?30.86 Kg/m2,mean 21.67 ± 2.78 Kg/m2;follow-up time 7.15 12.45 months,an average of 9.93 ± 1.27 months.Among retrospective control patients,ages 20 to 62 years,mean 39.17±11.53 years;weight 47.4 to 85 kg,average 61.39±9.46 kg;height 156 to 180 cm,average 168.90±6.45 cm;BMI 17.21 to 28.4 Kg/m2,The average was 21.37±3.02 Kg/m2;the follow-up time was 7.2 to 13.42 years,with an average of 10.31±1.56 years.There was no statistically significant difference in the basic information between the observation group and the control group,and they were comparable.The values of hip inner medial clearance,medial clearance,acetabular span,and steamed bread index in the two groups were all P>0.05.The difference was not statistically significant and comparable.The values of the hip medial clearance,the ratio of the medial hip clearance,the lateral offset of the femoral head,and the P value of the steamed bread index in the observation group and the control group before and after treatment were all significantly less than 0.05,indicating a significant difference between the two groups.Meaning.The change of muscle strength of the abductor muscle before and after treatment in the observation group(peak torque,peak value of average torque)was statistically significant(P<0.05).The VAS pain scores,Harris scores,iHOT-12 scores,and SF-12 quality of life were all significantly lower than 0.05,indicating that the VAS pain scores,Harris scores,iHOT-12 scores,and SF-12 quality of life scores were significant before and after treatment.Change,statistically significant before and after comparison.Conclusion1.Hip abductor muscle exercise can significantly increase the strength of the abductor muscle,increase muscle torque peak,improve muscle performance,to maintain joint stability plays an important role.2.Hip medial clearance ratio and acetabular head index can reflect the situation of femoral head dislocation,while the medial clearance ratio more accurately reflect the widening of the medial femoral head gap.3.Hip abductor muscle strength increased to a certain extent,the status of subluxated femoral head,narrowing the medial hip space,increase the hip medial clearance ratio and acetabular index.4.Lateral skewness of femoral head is an index that reflects the inward and outward movement of the femoral head.It can directly reflect the extent of internal and external changes in the overall position of the femoral head in the evaluation of femoral head necrosis combined with subluxation.5.Abductor muscle exercise may have long-term correction of subluxation has a certain effect,by maintaining the stability of the joint,promoting joint repair and stability,to delay the collapse,that is,stability of the head to promote intra-head stability.