全髋关节置换术后脱位21例临床分析

Clinical analysis on 21 cases of dislocation after total hip replacement

目的分析全髋关节置换术后脱位的影响因素,探讨术中如何准确置入髋关节假体以减少髋关节脱位。方法分析我科2005年1月—2012年12月全髋关节置换术后脱位病例的影响因素。结果本组病人脱位发生率为1.3%。女性占脱位人数的比例为62%,男性占38%。早期脱位占脱位人数的比例为90%,晚期脱位占10%。前方脱位占脱位人数的比例为19%,后方脱位占81%。假体位置不良占脱位人数的比例为52%,精种神经功能不全者占29%,术后活动范围过度者占脱位人数的比例为19%。结论患者因素、术者因素及髋关节假体因素都对人工髋关节置换术后脱位产生影响,术中准确置入髋关节假体是影响髋关节脱位的关键因素。

Objective To analyze the influencing factors of dislocation after total hip replacement, and research the methods how to imbed the prosthesis precisely in the operation. Methods The influencing factors of dislocation were analyzed on the patients who had undergone total hip replacement in the eight years （from January 2005 to December 2012 ）. Results The dislocation rate was 1.3% , females accounting for 62%o and males 38% ; 90% of the dislocation occurred in early stage （ 〈 6 weeks） , and 10% in later period （ 〉 6 weeks） ; anterior dislocation of hip joint happened in 19% , and posterior dislocation of hip joint in 81%. As for the causes of dislocation, 52% of the cases were because of an inaccurate prosthesis position, 29% because of an abnormal psychic or nerve system, and 19% because of an excessive range of motion. Conclusion The dislocation of prosthesis after total hip re- placement was influenced by such factors as patient, operator and prosthesis. Imbedding the prosthesis precisely is the key.