Bandyopadhyay Bratati, Datta Sunandan, Hussain Mohammed, Raza Muhammad, Mansoor Maham, Madhu Rachala, Kar Sudipta
Trauma and Orthopedics, Aneurin Bevan University Health Board, Newport, GBR.
Cureus. 2025 Apr 27;17(4):e83059. doi: 10.7759/cureus.83059. eCollection 2025 Apr.
Introduction Total hip replacement (THR) dislocation occurs when the prosthetic joint components completely separate, indicating a failure in the intended mechanics of the hip joint established by the prosthesis. This complication poses significant challenges for patients and surgeons and financially burdens healthcare systems. Methods This retrospective observational study evaluated cases of prosthetic hip dislocation within our health board that required manipulation under anesthesia (MUA) from January 1, 2021, to March 5, 2024. A total of 60 patients met the inclusion criteria. Patient data were collected from hospital records using dedicated clinical software platforms. Results The patients were divided into two groups based on the treatment received: MUA and revision THR. The Mann-Whitney U test showed no significant difference in the time to dislocation between the groups, but there was a notable difference in the number of dislocations. Posterior dislocations were the most common, occurring in 36 patients (60%). Of the 60 dislocated hips, 22 (36.67%) required revision surgery, while the remaining 38 cases were managed with MUA. The main cause of dislocation was noncompliance with recommended hip positioning. Conclusions Prosthetic hip dislocation remains a challenging complication following THR. Our analysis underscores the importance of monitoring for late dislocations and emphasizes the need for thorough patient education and adherence to postoperative precautions. Future multicenter studies are needed to validate our findings and develop standardized protocols to reduce dislocation risks.
引言
全髋关节置换术(THR)脱位是指假体关节组件完全分离,这表明假体所建立的髋关节预期力学机制出现故障。这种并发症给患者和外科医生带来了重大挑战,并给医疗系统带来经济负担。
方法
这项回顾性观察性研究评估了2021年1月1日至2024年3月5日期间在我们健康委员会内需要在麻醉下手法复位(MUA)的人工髋关节脱位病例。共有60名患者符合纳入标准。使用专用临床软件平台从医院记录中收集患者数据。
结果
根据接受的治疗方法,将患者分为两组:MUA组和翻修THR组。曼-惠特尼U检验显示两组之间脱位时间无显著差异,但脱位次数存在显著差异。后脱位最为常见,发生在36例患者中(60%)。在60例脱位髋关节中,22例(36.67%)需要翻修手术,其余38例采用MUA治疗。脱位的主要原因是未遵守推荐的髋关节位置。
结论
人工髋关节脱位仍然是THR术后具有挑战性的并发症。我们的分析强调了监测晚期脱位的重要性,并强调了对患者进行全面教育和遵守术后预防措施的必要性。未来需要多中心研究来验证我们的发现,并制定标准化方案以降低脱位风险。