初次人工全髋关节置换术后早期脱位原因分析及防治方法

The Reason and Treatment of Early Dislocation after Primary Tota Hip Arthroplasty

目的探讨初次人工全髋关节置换术后早期脱位的原因及防治方法。方法对2004年6月至2010年4月以来于我院住院期间发生脱位的患者进行随访,并记录患者一般情况、脱位类型、脱位发生时间及处理方法。通过髋关节术后X线片测量髋臼及股骨假体外展角和前倾角。结果共1 3例患者于住院期间发生脱位,脱位的发生率为3.1%,脱位均发生于改变体位时。髋关节术后X线片提示髋臼及股骨假体位置良好。采用闭合复位及下肢制动的方法,有3例患者住院期间再次发生脱位,所有患者出院后至随访时未再发生脱位。结论全髋关节置换术后脱位是多个危险因素共同作用的结果,最常见的为体位性因素。脱位发生后多数可通过闭合复位的方法得到有效治疗。

Objective To investigate the reason and treatment of early dislocation after total hip arthroplasty.Methods A series of patients,who had undergone primary THA from June 2004 to April 2010 and developed dislocation during hospital stay,were retrospectively reviewed.Risk factors and treatment protocol for dislocation were investigated.Results 13 patients had dislocation during hospital stay,and the dislocation rate was 3.1%.Postoperative X-ray showed the implants had good position.All the dislocation occurred while the patients changed their position.Close reduction and immobilization were performed.3 patients suffered second dislocation during hospital stay,but none of the 13 patients had dislocation after discharge.Conclusion Dislocation after total hip arthroplasty is a result of many risk factors,and the change of body position is most common.Close reduction and immobilization was effective to deal with early dislocation.