全髋关节置换后假体脱位危险因素的最新进展

Risk factors for prosthetic dislocation after total hip arthroplasty:recent progress

背景:全髋关节置换后假体脱位是关节外科面临的难题,随着关节外科手术技术的快速发展,术后假体脱位的问题愈发受到重视。国内外研究发现,在术前评估与规划、手术方式以及术后康复中均存在潜在因素导致术后假体脱位的发生,对于相关危险因素的认识越来越全面。目的:概述关于全髋关节置换后假体脱位危险因素的最新研究进展,为临床治疗提供参考。方法:利用计算机检索CNKI、万方、PubMed及Embase数据库1970年1月至2019年9月的相关文章,检索词为"全髋关节置换术,假体,术后脱位,危险因素,total hip arthroplasty,prosthesis,postoperative dislocation,risk factors"。查阅相关文章,最终共纳入77篇文献进行结果分析。结果与结论:①导致全髋关节置换后假体脱位的危险因素包括不全面的术前评估与规划、不合理的手术方式以及不科学的术后康复;②全髋关节置换后假体脱位会严重影响手术效果,因此在术前、术中及术后的各个环节都应采取预防措施,避免脱位的发生。

BACKGROUND:Prosthetic dislocation after total hip arthroplasty is a problem faced by joint surgery.With the rapid development of joint surgery techniques,the problem of postoperative prosthetic dislocation has become increasingly important.Research by scholars in and outside China has found that there are potential factors in preoperative evaluation and planning,surgical methods and postoperative rehabilitation leading to the occurrence of postoperative prosthetic dislocation.The understanding of related risk factors is becoming more comprehensive.OBJECTIVE:To summarize the latest research progress on the risk factors of prosthetic dislocation after total hip arthroplasty,and provide reference for clinical treatment.METHODS:The computer was used to search CNKI,Wanfang,PubMed and Embase databases from January 1970 to September 2019.The search terms were“total hip arthroplasty,prosthesis,postoperative dislocation,risk factors”.Relevant articles were consulted,and finally 77 literatures were included to analyze the results.RESULTS AND CONCLUSION:(1)The risk factors for postoperative dislocation after total hip arthroplasty include incomplete preoperative evaluation and planning,unreasonable surgical methods,and unscientific postoperative rehabilitation.(2)The prosthetic dislocation after total hip arthroplasty will seriously affect the surgical effect.Therefore,precautions should be taken in each link before,during and after the operation to avoid the occurrence of dislocation.