Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
BMC Musculoskelet Disord. 2022 Oct 20;23(1):926. doi: 10.1186/s12891-022-05876-8.
Posterior dislocation (PD) is a common complication after total hip arthroplasty (THA), and the Allis maneuver is the most widely used method for reduction. However, this classic maneuver has some disadvantages. The aim of the present study was to investigate whether a modified lateral position (MLP) reduction maneuver provides an easier and safer method for PD reduction than the Allis maneuver.
Between August 2019 and September 2021, a series of 88 consecutive PD patients who underwent THA were retrospectively evaluated. The patients were divided into the MLP reduction group and Allis reduction group according to the electronic health medical record. The success rate of closed reduction, Harris hip score (HHS), and radiographic outcomes were determined. Satisfaction scores, doctor safety events and complications were also determined and compared between the groups. The mean follow-up period was 1.66 ± 0.88 years.
The success rate of reduction in the MLP group was significantly 12.5% higher than that in the Allis group (P = 0.024). Periprosthetic fracture and implant loosening were retrospectively identified in 2 hips and 1 hip, which all occurred in the Allis group. The mean doctor and patient SAPS scores in the MLP group were 84.00 points and 76.97 points, respectively, which were significantly higher than those in the Allis group (72.12, P = 0.008 and 63.28 points, P = 0.001). Four adverse events were reported in the Allis group, compared with 0 in the MLP group.
For PD after THA, the MLP reduction maneuver can effectively increase the reduction success rate, satisfaction, and doctor safety without increasing the risk of complications compared with the traditional Allis supine reduction maneuver.
This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100054562) in December 19th 2021.
全髋关节置换术后（THA）后发生后脱位（PD）是一种常见并发症，Allis 手法是最常用的复位方法。然而，这种经典手法有一些缺点。本研究旨在探讨改良侧卧位（MLP）复位手法是否比 Allis 手法更简单、更安全地用于 PD 复位。
回顾性分析 2019 年 8 月至 2021 年 9 月期间连续 88 例接受 THA 的 PD 患者。根据电子健康病历将患者分为 MLP 复位组和 Allis 复位组。确定闭合复位成功率、Harris 髋关节评分（HHS）和影像学结果。比较两组的满意度评分、医生安全事件和并发症。平均随访时间为 1.66±0.88 年。
MLP 组复位成功率显著高于 Allis 组（12.5%，P=0.024）。2 髋和 1 髋分别出现假体周围骨折和假体松动，均发生在 Allis 组。MLP 组医生和患者 SAPS 评分分别为 84.00 分和 76.97 分，明显高于 Allis 组（72.12 分，P=0.008 和 63.28 分，P=0.001）。Allis 组报告了 4 例不良事件，而 MLP 组无不良事件。
对于 THA 后 PD，与传统的 Allis 仰卧复位手法相比，MLP 复位手法可有效提高复位成功率、满意度和医生安全性，而不会增加并发症风险。
本研究于 2021 年 12 月 19 日在中国临床试验注册中心（ChiCTR2100054562）注册。
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