全髋关节置换术中缝线锚入法修补后关节囊预防早期脱位  

Posterior articular capsule repair through anchored stitch for prevention of posterior dislocation after total hip arthroplasty

作　　者：夏冰[1] 朱丹杰[1] 毕擎[1] 洪剑飞[1] 邱斌松[1] 章水均[1] 顾海峰[1] 赵晨[1] 

机构地区：[1]浙江省人民医院骨科,杭州310014

出　　处：《浙江医学》2010年第7期1011-1013,共3页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目（2008B008）

摘　　要：目的探讨全髋关节置换术中应用缝线锚入法修复后路软组织预防术后早期脱位的临床疗效和应用价值。方法回顾性分析42例全髋关节置换术中采用缝线锚入法修补后关节囊的病例，研究锋线锚入法对预防早期脱位的作用。术中F型切开并完整保留后关节囊。取5号EHTIBOND缝线4根。中部对折。打结2个后置入髓腔。使缝线依靠线结锚着在股骨假体与髓腔后壁间。深度约2～3cm，作为后关节囊股骨侧止点，使切开之关节囊及外旋小肌群一起缝合固定于股骨颈后壁。术后观察早期的安全活动范围及脱位情况，并采用Harris髋关节评分标准进行评价。结果本组中无术后髋关节脱位出现，无感染及假体松动出现。Harris髋关节评分优良率97．6％。结论全髋关节置换术中锚入式缝合法修补后关节大大增加了髋关节的后方稳定性，能够有效地预防术后早期后脱位的发生，且允许术后早期有更大的活动范围，值得临床推广应用。Objective To evaluate the posterior articular capsule repair through anchored stitch in prevention of posterior dislocation after hip replacement. Methods Forty two patients underwent posterior articular capsule repair through anchored stitch, the clinical data were analyzed retrospectively. Four sutures of EHTIBOND （5#） which were conduplicated and tied a knot twice were anchored between the bone and prothesis in the posterior part of femoral medullary cavity. The depth was 2-3 cm and the interval was 0.5-0.8 cm. The posterior structure including articular capsule and the short external rotator muscle were fixed on the paries posterior of femoral neck by mattress suture. The function of hip was evaluated by Harris hip scores. Results All the cases were followed up. No case of dislocation, infection and loosening was found. The excellent postoperative rate of Harris hip scores were 97.6%. Conclusion Posterior structure repair by anchored suture in hip displacement can not only prevent the dislocation but also improve the stability of hip joint and permit more range of joint motion in the early postoperative time and worth being generalized.

关 键 词：关节成形术 置换 髋 脱位 关节囊 

分 类 号：R687.4[医药卫生—骨科学]