Loubignac F, Boissier F
Service de chirurgie orthopédique et réparatrice, Hôpital Renée Sabran, Presqu'5bile de Giens, Hyères.
Rev Chir Orthop Reparatrice Appar Mot. 1997;83(5):469-72.
Close reduction of a bipolar hemiarthroplasty dislocation may induce dissociation between the cup and the prosthetic ball head. This rare complication leads to reoperation.
Two women 84 and 85 years' old suffering from femoral head fracture were treated by bipolar hemiarthroplasty through a postero-lateral approach. After the first post-operative month, a posterior dislocation has occurred. Close reduction, without anesthesia dislocated the intraprosthetic joint.
Dislocation rate is lower for bipolar hemiarthroplasty than for total hip arthroplasty. Reason for these two dislocation was supposed to be a "bottle-opener" effect's by locking the cup on to the posterior acetabular rim. Limb traction is responsible for intra-prosthetic iatrogenic dislocation.
Anesthesia should be considered as necessary for prosthesis bipolar hemiarthroplasties dislocation treatment. The authors have moved to a different implant and modified their surgical approach (antero lateral). These modifications were introduced in order to reduce the rate of hip dislocation and above all the event of intraprosthetic dislocation when close reduction was necessary.
双极半髋关节置换术脱位的闭合复位可能会导致髋臼杯与假体球头分离。这种罕见的并发症会导致再次手术。
两名分别为84岁和85岁的女性因股骨头骨折接受了经后外侧入路的双极半髋关节置换术。术后第一个月后发生了后脱位。在未麻醉的情况下进行闭合复位导致了假体关节脱位。
双极半髋关节置换术的脱位率低于全髋关节置换术。这两例脱位的原因被认为是由于髋臼杯锁定在后髋臼边缘产生的“开瓶器”效应。肢体牵引是假体内部医源性脱位的原因。
对于假体双极半髋关节置换术脱位的治疗，应考虑进行麻醉。作者已更换为不同的植入物并修改了手术入路（前外侧）。引入这些修改是为了降低髋关节脱位率，尤其是在需要进行闭合复位时假体内部脱位的发生率。
