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评估初次全髋关节置换术后伴同侧内翻膝畸形患者的术后脱位率。

Evaluation of the rate of post-operative dislocation in patients with ipsilateral valgus knee deformity after primary total hip arthroplasty.

机构信息

Department of Orthopaedics, West China Hospital, Sichuan University, 37# Wuhou Guoxue Road, Chengdu, China.

出版信息

Int Orthop. 2022 Jul;46(7):1507-1514. doi: 10.1007/s00264-022-05372-7. Epub 2022 Mar 20.

Abstract

PURPOSE

There is scant literature on the evaluation of dislocation after total hip arthroplasty (THA) in patients with ipsilateral valgus knee deformity. This study aimed to investigate the post-operative dislocation rate in patients with valgus knee deformity who underwent ipsilateral THA and identify whether ipsilateral valgus knee deformity increases the dislocation rate after THA.

METHODS

We retrospectively reviewed patients with valgus knee deformity who underwent ipsilateral THA in our institution from January 2016 to December 2018. Each hip with ipsilateral valgus knee deformity was matched with a hip without valgus knee deformity according to sex, affected side, and date of surgery. The primary outcome was the dislocation rate after THA. Univariate analyses were initially used to compare data between the dislocation group and the non-dislocation group. Independent risk factors for dislocation were determined using multivariate logistic regression.

RESULTS

There were 257 THAs with ipsilateral valgus knee deformity (valgus knee group) and 257 THAs without valgus knee deformity (control group). The valgus knee group showed a significantly higher dislocation rate than the control group (9.7% versus 1.6%, p < 0.001). Older age (p = 0.020) and malposition of the acetabular cup (p = 0.048) were independent risk factors of post-operative dislocation.

CONCLUSION

Patients with valgus knee deformity have a higher risk of dislocation after ipsilateral THA. If ipsilateral THA and total knee arthroplasty must be performed successively, total knee arthroplasty may have an earlier priority than THA.

摘要

目的

关于伴有同侧内翻膝畸形的全髋关节置换术后(THA)脱位的评估,文献报道甚少。本研究旨在探讨伴有内翻膝畸形的患者行同侧 THA 后的脱位发生率,并确定同侧内翻膝畸形是否会增加 THA 后的脱位率。

方法

我们回顾性分析了 2016 年 1 月至 2018 年 12 月在我院行同侧 THA 的内翻膝畸形患者。根据性别、患侧和手术日期,将每例伴有同侧内翻膝畸形的髋关节与无内翻膝畸形的髋关节相匹配。主要结局是 THA 后脱位率。首先采用单变量分析比较脱位组和非脱位组之间的数据。采用多变量逻辑回归确定脱位的独立危险因素。

结果

共纳入 257 例伴有同侧内翻膝畸形的 THA(内翻膝组)和 257 例无内翻膝畸形的 THA(对照组)。内翻膝组的脱位率明显高于对照组(9.7%比 1.6%,p<0.001)。年龄较大(p=0.020)和髋臼杯位置不良(p=0.048)是术后脱位的独立危险因素。

结论

伴有内翻膝畸形的患者行同侧 THA 后脱位风险较高。如果同侧 THA 和全膝关节置换术必须连续进行,全膝关节置换术可能比 THA 具有更早的优先性。

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