Charissoux J-L, Asloum Y, Marcheix P-S
Service d'orthopedie traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
Service d'orthopedie traumatologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
Orthop Traumatol Surg Res. 2014 Feb;100(1 Suppl):S25-34. doi: 10.1016/j.otsr.2013.11.008. Epub 2014 Jan 13.
Dislocation is a major complication of total hip arthroplasty (THA), whose frequency has been unaffected by improvements in surgical techniques and implants. The dislocation rate depends on multiple factors related to the patient, hip disease, and surgical procedure and is therefore also dependent on the surgeon. The many published studies on THA dislocation, its causes, and its treatment have produced conflicting results. The objective of this work is to review the management of THA dislocation, which is a severe event for both the patient and the surgeon. This lecture starts with a brief review of data on THA dislocation rates and the many factors that influence them. Emphasis is then put on the evaluation for a cause and, more specifically, on the challenges raised by detecting suboptimal cup position. Next, reported techniques for treating THA dislocation and the outcomes of each are discussed. Finally, a management strategy for patients selected for revision surgery is suggested.
脱位是全髋关节置换术（THA）的一种主要并发症，其发生率并未因手术技术和植入物的改进而受到影响。脱位率取决于与患者、髋关节疾病及手术操作相关的多种因素，因此也取决于外科医生。众多关于THA脱位、其病因及治疗的已发表研究结果相互矛盾。这项工作的目的是回顾THA脱位的处理方法，这对患者和外科医生来说都是一个严重事件。本次讲座首先简要回顾THA脱位率的数据以及影响脱位率的诸多因素。然后重点讨论病因评估，更具体地说，是检测髋臼位置欠佳所带来的挑战。接下来，讨论已报道的治疗THA脱位的技术及其各自的疗效。最后，针对选择进行翻修手术的患者提出一种处理策略。
