Blom Ashley W, Rogers Mark, Taylor Adrian H, Pattison Giles, Whitehouse Sarah, Bannister Gordon C
Avon Orthopaedic Centre, Southmead Hospital, Westbury-on-Trym, Bristol, UK.
Ann R Coll Surg Engl. 2008 Nov;90(8):658-62. doi: 10.1308/003588408X318156. Epub 2008 Sep 30.
The aim of this study was to determine the incidence and outcome of dislocation after total hip arthroplasty at our unit.
In total, 1727 primary total joint arthroplasties and 305 revision total hip arthroplasties were performed between 1993 and 1996 at our unit. We followed up 1567 (91%) of the primary hip arthroplasties and 284 (93%) of the revision hip arthroplasties at 8-11 years after surgery. Patients were traced by postal questionnaire, telephone interview or examination of case notes of the deceased.
The dislocation rates by approach were 23 out of 555 (4.1%) for the posterior approach, 0 out of 120 (0%) for the Omega approach and 30 out of 892 (3.4%) for the modified Hardinge approach. Of dislocations after primary total hip arthroplasty, 58.5% were recurrent. The mean number of dislocations per patient was 2.81. Overall, 8.1% of revision total hip arthroplasties dislocated. 70% of these became recurrent. The mean number of dislocations per patient was 2.87. The vast majority of dislocations occurred within 2 months of surgery.
To our knowledge, this is the largest multisurgeon audit of dislocation after total hip arthroplasty published in the UK. The follow-up of 8-11 years is longer than most comparable studies. The results of this study can be used to inform patients as to the risk and outcome of dislocation, as well as to the risk of further dislocation.
本研究旨在确定我院全髋关节置换术后脱位的发生率及预后情况。
1993年至1996年间，我院共进行了1727例初次全关节置换术和305例翻修全髋关节置换术。我们对1567例（91%）初次髋关节置换术患者和284例（93%）翻修髋关节置换术患者在术后8至11年进行了随访。通过邮寄问卷、电话访谈或查阅已故患者病历的方式对患者进行追踪。
后路手术的脱位率为555例中有23例（4.1%），欧米伽入路为120例中0例（0%），改良哈丁入路为892例中有30例（3.4%）。初次全髋关节置换术后发生的脱位中，58.5%为复发性脱位。每位患者脱位的平均次数为2.81次。总体而言，8.1%的翻修全髋关节置换术发生了脱位。其中70%变为复发性脱位。每位患者脱位的平均次数为2.87次。绝大多数脱位发生在术后2个月内。
据我们所知，这是英国发表的关于全髋关节置换术后脱位的规模最大的多外科医生审计研究。8至11年的随访时间比大多数同类研究更长。本研究结果可用于告知患者脱位的风险及预后情况，以及再次脱位的风险。
