髋关节置换术后早期失败原因的回顾性分析

A retrospective review of postoperative failure in the early stage after hip replacement

目的探讨髋关节置换术后早期失败的原因和特点。方法对1995年1月至2009年1月本组收治的342例初次髋关节置换(THA)失败患者进行回顾性分析,将这些失败的患者分为早期失败组(初次髋关节置换术后(5年内失败组)和晚期失败组(初次髋关节置换术后(5年失败组),再对早期失败组患者的翻修原因进行分析。结果以髋关节翻修作为终止点,42.1%(144/342)的患者在初次THA术后5年内进行翻修,在早期失败的两个主要原因中,31.2%是因为无菌性松动,24.3%是因为髋关节脱位。结论THA术后早期的失败原因是无菌性松动和髋关节脱位。外科医师要提高手术技术,以避免THA术后的早期失败。

Objective To analyze the early failure mechanisms and characteristics in patients who had revision surgery within 5 years after hip arthroplasty.Methods We retrospectively reviewed 342 revision hip arthroplasties performed in 339 patients from Jan 1995 to Jan 2009. Then we stratified these patients into two groups： early failure group （less than 5 years） and late failure group （more than 5 years） after index hip arthroplasty. We analyze the early failure mechanisms of hip arthroplasty.Results 144 of 342 （42.1%） revisions occurred in less than 5 years, with 31.2% resulting from aseptic loosening and 24.3% due to dislocation.Conclusions The majority of the causes of failure within 5 years in these early revisions were aseptic loosening and dislocation. The surgeons should improve surgical technique to avoid early failures of hip replacement.