Díaz-Ponte Santiago, Aristizábal-Jaramillo Camilo, Palencia-Escorihuela Maria, Bonilla Guillermo, Ortíz-Martínez Juan Guillermo
Faculty of Medicine, Universidad de La Sabana, Chía, Colombia.
Trauma and Rehabilitation Research Group, Universidad de La Sabana, Chía, Colombia.
J Orthop Surg Res. 2025 Jul 14;20(1):648. doi: 10.1186/s13018-025-05746-8.
Total hip arthroplasty (THA) is a procedure primarily performed for hip osteoarthritis. Dislocation rates after primary THA range from 0.7 to 2%, remaining a key concern. Variability in surgical approaches, especially regarding posterior soft tissue repair, underscores the need for evidence specific to osteoarthritis. This review evaluates the impact of soft tissue repair on reducing dislocation rates in THA via posterior and posterolateral approach.
An exploratory systematic review was conducted to evaluate the effect of soft tissue repair on dislocation rates following THA for osteoarthritis. Studies in English and Spanish were included, focusing on posterior approach repairs. Searches were done in PubMed, Scopus, and Google Scholar. Three reviewers independently assessed study quality and extracted relevant data, using tools like APPRAISE-AI and PROBAST.
Out of 478 initially identified publications, 13 studies met the inclusion criteria. The studies focused on the impact of soft tissue management on hip dislocation following THA in patients with osteoarthritis. Results consistently showed that preserving or repairing the external rotator muscles reduced dislocation rates, with tendon-to-bone repair proving most effective among the existing techniques for soft tissue and external rotator repair.
Soft tissue repair using the tendon-to-bone technique enhances hip stability and reduces the risk of dislocation in total hip arthroplasty for osteoarthritis. Preventive strategies should be tailored to individual risk factors, as personalized approaches are essential for optimizing outcomes in osteoarthritis patients with a high comorbidity burden.
全髋关节置换术（THA）主要用于治疗髋关节骨关节炎。初次全髋关节置换术后的脱位率在0.7%至2%之间，仍然是一个关键问题。手术入路的差异，尤其是在后方软组织修复方面，凸显了针对骨关节炎的特定证据的必要性。本综述评估了软组织修复对通过后方和后外侧入路进行的全髋关节置换术中降低脱位率的影响。
进行了一项探索性系统综述，以评估软组织修复对骨关节炎患者全髋关节置换术后脱位率的影响。纳入了英文和西班牙文的研究，重点是后方入路修复。在PubMed、Scopus和谷歌学术上进行了检索。三位评审员独立评估研究质量并提取相关数据，使用APPRAISE-AI和PROBAST等工具。
在最初识别的478篇出版物中，有13项研究符合纳入标准。这些研究聚焦于软组织处理对骨关节炎患者全髋关节置换术后髋关节脱位的影响。结果一致表明，保留或修复外旋肌可降低脱位率，在现有的软组织和外旋肌修复技术中，肌腱-骨修复被证明是最有效的。
采用肌腱-骨技术进行软组织修复可增强髋关节稳定性，并降低骨关节炎患者全髋关节置换术中脱位的风险。预防策略应根据个体风险因素进行调整，因为个性化方法对于优化合并症负担高的骨关节炎患者的治疗效果至关重要。
