全髋关节置换术后脱位的防治  

The prevention and treatment of dislocation after total hip arthroplasty

作　　者：董玉雷[1] 翁习生[1] 

机构地区：[1]100730中国医学科学院北京协和医学院北京协和医院骨科

出　　处：《中华解剖与临床杂志》2014年第1期67-70,共4页Chinese Journal of Anatomy and Clinics

摘　　要：目的总结全髋关节置换术（THA）后脱位的危险因素及防治策略。方法查阅近年来全髋关节置换术后脱位的相关文献，分析术后脱位的危险因素及目前的预防策略进展。总结对于反复脱位的病例采用的治疗方式。结果全髋关节置换术后脱位的影响因素是多方面的，包括患者因素、手术因素、假体设计、软组织张力等。防治措施包括辨别患者的风险因素，避免假体组件位置不良，注意髋部的软组织平衡，确保足够的股骨偏心距，恢复髋部的生物力学环境，最大化头、颈率，对于脱位高风险患者，使用限制性髋臼组件。结论针对全髋关节置换术后脱位高危因素采取相应的预防措施，可降低术后脱位的风险。一旦出现脱位，辨别髋关节不稳定的原因，然后有针对性地进行矫正，才能取得治疗的成功。Objective To analyze the risk factors and preventive strategy of dislocation after total hip arthroplasty. Methods The database was searched and relevant references were analyzed. Risk factors of dislocation were identified and the advances in the prevention and treatment of dislocation were also analyzed. Results The cause of dislocation is multifactorial including patient related factors, surgery factors, prosthesis design, and soft tissue tension, etc. The strategy to decrease the risk including identifying the patient related factors, avoiding malposition of the prothesis, reconstruction of enough offset and soft tissue tension, maximum of the head-neck ratio, and applying to restrictive component in high risky patients. Conclusions Identifying the risk factors and taking the related preventive measure is necessary to decrease the dislocation risk. As for the recurrent case, finding out the cause of the hip instability and performing the revision surgery will often succeed.

关 键 词：关节成形术 脱位 危险因素 手术后并发症 

分 类 号：R687.4[医药卫生—骨科学]