全髋关节置换术后早期脱位的原因分析

The causes of early dislocation after total hip replacement

目的分析全髋关节置换术后早期髋关节脱位原因,探讨防治方法。方法自1986年6月～2001年10月,596例(632髋)全髋关节置换术病例中,共有19例发生早期脱位。分别对这19例早期脱位的多方面进行评估。结果该组早期髋关节脱位发生率为3.0%(19/632髋),脱位多发生在术后1～6周,多因姿势不当、超范围活动为诱因。X线检查,有7例假体位置不良,12例髋周软组织不平衡,髋部外展肌力乏力11例。结论全髋关节置换术后早期脱位由多种因素引起,假体位置不良、软组织张力低和外展肌力乏力是目前引起早期脱位主要原因。

Objective To analyze the causes of early disloc ation after total hip replacement (THR)and discuss its prevention and treat-ment.Method596cases(632hips)who received total hip replacement were analyzed.Among them,19cases(19hips)who suffered from early hip dislocation were followed up.The strendth of their hip abducto r were tested and the X-ray films (A-P view)of their pelvis were measured.Result In our cases,the incidence of the early dislocation after THR was 3.0%.In most cases,the dislocation were led by in-appropriate postoperative transportation and rehabilitation.Radiologically,implant malposition coul d be detected in 7hips,inadequate soft-tissue tension in 12hips and we akness of the abductor musculature i n 11hip.Conclusion The causes of early dislocation afte r total hip replacement are multiple factor.The implant malposition,inadequate soft-tissue tension sur rounding the hip and weakness of the a bductor musculature are the main factor at pr esent.