Meek R M D, Allan D B, McPhillips G, Kerr L, Howie C R
Orthopaedic Department, Southern General Hospital, Glasgow, UK.
Clin Orthop Relat Res. 2006 Jun;447:9-18. doi: 10.1097/01.blo.0000218754.12311.4a.
Instability after total hip arthroplasty is an important complication. It usually occurs in the immediate postoperative period, but the risk also increases with time. There are numerous surgical treatment options, but they have relatively unpredictable outcomes. Numerous factors are associated with dislocation, but research has mainly focused on surgical factors. Epidemiological factors remain the subject of much debate. We aimed to establish the most significant epidemiological factors in Scotland and in particular the dislocation rate in neuromuscular conditions. The Scottish National arthroplasty nonvoluntary registry is based on SMR01 records (Scottish Morbidity Record) data. We analyzed the Scottish National Arthroplasty Project to find patients' dislocation rates up to 1 year postoperatively for surgeon volume, age, gender, previous surgery, diagnosis, and followup duration. There were 14,314 total hip arthroplasties performed from April 1996 to March 2004 with an annual incidence of dislocation of 1.9%. We found an association between rate of dislocation with age, surgical volume, and previous fracture. However, there was no increase in the rate of dislocation associated with gender or with diagnoses of stroke or Parkinson's disease. Our prognostic assessment of dislocation risk allows assessment for methods of reducing dislocation in high risk patients.
全髋关节置换术后的不稳定是一种重要的并发症。它通常发生在术后即刻，但风险也会随着时间增加。有多种手术治疗选择，但它们的结果相对难以预测。有许多因素与脱位有关，但研究主要集中在手术因素上。流行病学因素仍然是许多争论的主题。我们旨在确定苏格兰最重要的流行病学因素，特别是神经肌肉疾病中的脱位率。苏格兰国家关节成形术非自愿登记处基于SMR01记录（苏格兰发病率记录）数据。我们分析了苏格兰国家关节成形术项目，以找出患者术后1年内因外科医生手术量、年龄、性别、既往手术、诊断和随访时间的脱位率。1996年4月至2004年3月共进行了14314例全髋关节置换术，年脱位发生率为1.9%。我们发现脱位率与年龄、手术量和既往骨折之间存在关联。然而，与性别或中风或帕金森病诊断相关的脱位率没有增加。我们对脱位风险的预后评估有助于评估降低高危患者脱位的方法。
