Witjes S, Schrier J C M, Gardeniers J W M, Schreurs B W
Universitair Medisch Centrum St. Radboud, afd. Orthopedie 800, Postbus 9101, 6500 HB, Nijmegen.
Ned Tijdschr Geneeskd. 2007 Sep 1;151(35):1928-34.
To describe the complications within 2 years after revision of failed total hip prostheses.
Descriptive.
Using prospective registration, data were collected on the complications that had occurred in patients who had undergone hip revision in 2002 and 2003 on the orthopaedic department at the University Medical Centre St. Radboud in Nijmegen, The Netherlands.
The study group consisted of 67 patients, 47 women and 20 men, with an average age at time of revision of 62 (SD: 15.3). 67 revisions of total hip prostheses were performed: 64% underwent first revision and 36% re-revision. In 40% a cup revision only was performed, in 15% a femoral revision and 45% underwent total revision. The most frequent indications for revision were aseptic loosening (76%) and recurrent dislocation (13%). In 19% of the procedures a peroperative complication occurred, 2 patients died during follow up although not from operation-related causes, and in 51% of remaining patients a complication occurred within 2 years after surgery. The most frequently seen complications were dislocation (8%) and deep infection (5%). 2 of 3 deep infections were re-infections of earlier septic revisions. The most frequent complication was luxation. Together with recurrent dislocation, deep infection was the most frequent indication for a re-operation. The re-operation percentage was 12. 3 out of the 5 luxations that occurred were re-revised due to recurrent dislocation.
Hip revision procedures are associated with a high rate of complications within 2 years of implantation. The data are comparable with the limited amount of published data.
描述全髋关节置换失败翻修术后2年内的并发症情况。
描述性研究。
采用前瞻性登记,收集了2002年和2003年在荷兰奈梅亨圣拉德波德大学医学中心骨科接受髋关节翻修手术患者发生的并发症数据。
研究组由67例患者组成,其中47例女性,20例男性,翻修时的平均年龄为62岁(标准差:15.3)。共进行了67次全髋关节置换翻修手术:64%为初次翻修,36%为再次翻修。仅进行髋臼翻修的占40%,股骨翻修的占15%,全翻修的占45%。最常见的翻修指征是无菌性松动(76%)和复发性脱位(13%)。19%的手术发生了术中并发症,2例患者在随访期间死亡,但并非手术相关原因,其余患者中有51%在术后2年内出现并发症。最常见的并发症是脱位(8%)和深部感染(5%)。3例深部感染中有2例是早期感染性翻修后的再次感染。最常见的并发症是脱位。脱位与复发性脱位、深部感染一起是再次手术最常见的指征。再次手术率为12%。发生的5例脱位中有3例因复发性脱位进行了再次翻修。
髋关节翻修手术在植入后2年内并发症发生率较高。这些数据与已发表的有限数据相当。