后关节囊重建及外旋肌群修补预防全髋关节置换术或人工股骨头置换术后关节后脱位  

Posterior Arthrosis Capsule Reconstruction and Short External Rotator Muscle Repair for Prevention of Postoperative Arthrosis Posterior Dislocation with Total Hip Arthroplasty or Hemiarthroplasty

作　　者：汪璟[1] 李远景[1] 丘宏伟[1] 马勇[2] 宗世璋[2] 张德[1] 

机构地区：[1]汕头大学医学院附属韶关粤北人民医院骨科,广东韶关512026 [2]南昌大学第一附属医院骨科,南昌330006

出　　处：《实用临床医学（江西）》2012年第5期24-26,共3页Practical Clinical Medicine

摘　　要：目的探讨后关节囊重建及外旋肌修补对全髋关节置换术或人工股骨头置换术后关节后脱位的影响。方法以经后侧入路行初次全髋关节置换术或人工股骨头置换术患者65例作为A组,术中将后方关节囊及外旋肌群经数个骨孔固定于股骨大转子后方的骨质上。以经后侧手术入路、仅修补外旋肌群患者65例作为B组,术中后关节囊进行切除,外展角在30°～55°,前倾角在10°～20°,均使用防脱位内衬。并比较2组患者术后关节后脱位情况。结果2组患者术后随访3～24个月。A组患者术后关节后脱位1例(1.54%)。B组患者术后关节后脱位6例(9.23%),其中1例连续2次关节后脱位。A组患者术后关节后脱位发生率明显低于B组(P<0.05)。结论后关节囊及外旋肌群与股骨大转子之间的完整性重建有助于降低初次行后入路全髋关节置换术或人工股骨头置换术后关节后脱位的发生率。Objective To explore the effects of posterior arthrosis capsule reconstruction and short external rotator muscle repair for prevention of postoperative arthrosis posterior dislocation with total hip arthroplasty or hemiarthroplasty.Methods Sixty-five patients posterior approach total hip arthroplasty or hemiarthroplasty and 65 patients posterior approach short external rotator muscle repair were selected to serve as group A and group B,respectively.In group A,posterior arthrosis capsular flaps and short external rotator muscle were reattached to the posterior border of greater trochanter through several bone holes after replacement.In group B,posterior approach by rear and external rotator muscle repair.Resection of intraoperative posterior capsule,abduction angle between 30°-55°,anteversion between 10°-20°,Use anti-dislocation of the liner.The incidence of postoperative arthrosis posterior dislocation was compared between the two groups.Results Patients were followed-up for 3-24 months.Postoperative arthrosis posterior dislocation occurred in 1 patient in group A and in 6 patients（1 patient arthrosis posterior dislocated two times） in group B.The incidence of postoperative arthrosis posterior dislocation in group A was significantly lower than that in group B（1.54% vs 9.23%,P0.05）.Conclusion Posterior arthrosis capsule integrity of the reconstruction between greater trochanter and short external rotator muscle repair can reduce the incidence of postoperative arthrosis posterior dislocation after total hip arthroplasty or hemiarthroplasty through a posterior approach.

关 键 词：后脱位 全髋关节置换术 人工股骨头置换术 后关节囊 重建 外旋肌 修补 

分 类 号：R318.17[医药卫生—生物医学工程] R687.4[医药卫生—基础医学]