van Stralen G M J, Struben P J, van Loon C J M
Department of Orthopaedics, Ziekenhuis Rijnstate, PO Box 9555, 6800 TA Arnhem, The Netherlands.
Arch Orthop Trauma Surg. 2003 Jun;123(5):219-22. doi: 10.1007/s00402-003-0482-3. Epub 2003 Apr 9.
Dislocation after total hip arthroplasty (THA) is one of the most common major complications, and occurs more often through a posterior approach. We performed a retrospective study to determine the incidence of early dislocation and the relationship to the type of prosthesis and the surgeon's experience.
A group of 884 consecutive primary THAs (746 cemented and 138 cementless) approached through a posterior incision with repair of the posterior soft tissues was followed for a mean of 30 months.
The overall dislocation rate was 1.36% (cemented: 1.1%; cementless: 2.9%). All dislocations were posterior and occurred within 6 months after surgery, 91% within 6 weeks. Dislocations were most common in rheumatoid patients (3.8%). Two revisions (0.23%) of the acetabular cup were performed for recurrent dislocations. The dislocation rate was not higher in the operations performed by less experienced surgeons.
The early dislocation rate after primary THA through a posterior approach with repair of the posterior soft tissues was low, especially in cemented THA. Less experienced surgeons were not associated with a higher dislocation rate.
全髋关节置换术(THA)后脱位是最常见的主要并发症之一,且通过后入路发生的频率更高。我们进行了一项回顾性研究,以确定早期脱位的发生率以及与假体类型和外科医生经验的关系。
对一组884例连续的初次全髋关节置换术(746例骨水泥型和138例非骨水泥型)进行研究,这些手术通过后外侧切口进行,同时修复后方软组织,平均随访30个月。
总体脱位率为1.36%(骨水泥型:1.1%;非骨水泥型:2.9%)。所有脱位均为后方脱位,且发生在术后6个月内,91%发生在6周内。脱位在类风湿性关节炎患者中最为常见(3.8%)。因复发性脱位进行了2例髋臼杯翻修手术(0.23%)。经验不足的外科医生进行的手术中脱位率并不更高。
通过后入路并修复后方软组织的初次全髋关节置换术后早期脱位率较低,尤其是在骨水泥型全髋关节置换术中。经验不足的外科医生与更高的脱位率无关。