Patel Preetesh D, Potts Aaron, Froimson Mark I
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio 44195, USA.
J Arthroplasty. 2007 Jun;22(4 Suppl 1):86-90. doi: 10.1016/j.arth.2006.12.111.
The dislocating hip is functionally impairing and leads to patient dissatisfaction. The etiology is multifactorial and may include component malpositioning, soft tissue laxity, and component or anatomical impingement. Initial treatment of dislocation usually consists of closed reduction followed by the use of an abduction pillow or brace or a knee immobilizer, although evidence to support these actions is limited. Operative intervention is generally reserved for patients with more than 2 dislocations and should aim to correct the cause of dislocation using a simple algorithm. Proper component positioning is key to prevention of further dislocation, but other tools include modular implants, jumbo heads, and increased offset. Finally, constrained acetabular components may be considered if a patient fails one of the above surgical options.
髋关节脱位会导致功能受损，引起患者不满。其病因是多因素的，可能包括假体组件位置不当、软组织松弛以及组件或解剖结构撞击。脱位的初始治疗通常包括闭合复位，随后使用外展枕或支具或膝关节固定器，不过支持这些措施的证据有限。手术干预一般适用于脱位超过2次的患者，应采用简单的方案来纠正脱位原因。正确的组件定位是预防进一步脱位的关键，但其他手段包括模块化植入物、大头假体和增加偏心距。最后，如果患者上述手术选择均失败，可考虑使用限制性髋臼组件。
