全髋关节置换术后早期脱位的原因分析及防治

Reasons,prevention and treatment of early dislocation after total hip arthroplasty

目的分析初次人工全髋关节置换术(total hip arthrophasty,THA)术后假体脱位的原因,并探讨其防治方法。方法 2004年1月至2009年10月行初次THA患者420例,对术后脱位的6例患者进行回顾性分析,评价术后脱位的危险因素及防治对策。结果 6位患者发生住院期间脱位,发生率1.4%。患者活动超范围5例,假体位置不良1例。5例予闭合手法复位固定,1例经手术调整外展角度,改用长颈股骨头假体后获得成功。结论 THA后脱位是多个危险因素共同作用的结果,最常见为体位性因素。脱位发生后多数可通过闭合复位固定的方法得到有效治疗,但反复脱位及假体位置严重不良者应考虑手术。

Objective To analyze the reasons of early dislocation after primary total hip arthroplasty（THA） and to explore its prevention and treatment.Methods Among 420 cases of primary THA treated in our department from January 2004 to October 2009,6 cases of postoperative dislocation were retrospectively analyzed for evaluating their risk factors and countermeasure of prevention and treatment.Results 6 cases developed dislocation during hospitalization period,with the incidence rate of 1.4%.5 cases had over motion and 1 case had malposition of prosthesis.Close reduction and immobilization were succeeded in 5 cases,while 1 case was successfully treated by readjusting the abduction angle of acetabular cup and the femoral length.Conclusion Dislocation after primary THA is a result of joint action by many risk factors,and the change of body position is most common.Close reduction and immobilization are effective to deal with early dislocation,but operation should be done in the cases with frequent dislocation and severe malposition of prosthesis.