Brennan Stephen A, Khan Fahim, Kiernan Christine, Queally Joseph M, McQuillan Janette, Gormley Isobel C, O'Byrne John M
Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
Hip Int. 2012 Sep-Oct;22(5):500-4. doi: 10.5301/HIP.2012.9747.
6554 primary total hip arthroplasties were reviewed. Risk factors for dislocation were analysed to assess which were important in terms of predicting recurrent instability. The patients risk of having a second dislocation was independently associated with the surgical approach adopted (p = 0.03) and the time to first dislocation from the primary hip replacement (p = 0.002). Early dislocators whose surgery was performed through an anterolateral approach had less recurrence than late dislocators through a posterior or transtrochanteric approach. None of the other risk factors including head size (p = 0.59), modularity (p = 0.54), mechanism of dislocation (p = 0.23), leg length discrepancy (p = 0.69) and acetabular inclination (p = 0.31) were influential. The use of an abduction brace was not useful in preventing a further dislocation with 69.2% of those braced re-dislocating compared to 68.5% who were not braced (p = 0.96).
对6554例初次全髋关节置换术进行了回顾性研究。分析脱位的危险因素，以评估哪些因素在预测复发性不稳定方面具有重要意义。患者再次脱位的风险与所采用的手术入路（p = 0.03）以及初次髋关节置换术后首次脱位的时间（p = 0.002）独立相关。通过前外侧入路进行手术的早期脱位患者比通过后外侧或经大转子入路的晚期脱位患者复发率更低。包括股骨头大小（p = 0.59）、模块化（p = 0.54）、脱位机制（p = 0.23）、肢体长度差异（p = 0.69）和髋臼倾斜度（p = 0.31）在内的其他危险因素均无影响。使用外展支具对预防再次脱位并无帮助，使用支具的患者中有69.2%再次脱位，未使用支具的患者中有68.5%再次脱位（p = 0.96）。
