后关节囊拉花后重建对防止骨质疏松患者全髋关节置换术后脱位的作用  

Reconstruction after posterior articular capsule pie-crusting in prevention of dislocation of osteoporosis patients undergoing total hip arthroplasty

作　　者：许康永[1] 朱晨[2] 

机构地区：[1]宿州市立医院骨科,安徽宿州234000 [2]安徽医科大学附属省立医院骨科,安徽合肥230001

出　　处：《安徽医药》2016年第9期1676-1679,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金项目(81401815)

摘　　要：目的探讨髋关节后方关节囊拉花(pie-crusting)后经骨隧道重建对防止骨质疏松患者全髋关节置换术后假体髋关节后脱位的作用。方法回顾性分析经后外侧入路行初次全髋关节置换术且合并骨质疏松的患者531例。A组201例:不保留后方关节囊,B组174例:保留后方关节囊,后方关节囊经大转子骨隧道重建。C组156例:保留后方关节囊,后方关节囊拉花后经大转子骨隧道重建。比较三组患者术后假体髋关节的脱位率。结果三组患者中共12例(2.26%)患者发生脱位,均为后脱位。其中A组、B组、C组术后的脱位例分别是:9例(4.48%)、3例(1.72%)、0(0%)例,且C组术后脱位率与其它两组比较均明显低于A组和B组(P<0.05)。结论后方关节囊拉花后经大转子骨隧道重建有助于恢复髋关节软组织平衡,减少术后引起大转子撕脱性骨折而导致缝合失败的机会,对防止骨质疏松患者全髋置换术后假体后脱位有积极的作用。Objective To investigate the preventive effect of trans-bone reconstruction after hip joint posterior articular capsule pie-crusting on backward dislocation of hip prosthesis in post THA（total hip arthroplasty）patients.Methods A retrospective analysis was made of 531 patients who received THA with posterolateral approach for the first time during January 2011 to June 2015 complicating with osteoporosis.There were 201 cases in group A with unreserved posterior articular capsule,174 cases in group B with reserved pos-terior articular capsule,which was reconstructed with trans-greater trochanter approach,and 156 cases in group C with reserved posterior articular capsule,which was reconstructed with trans-greater trochanter approach after pie-crusting.Postoperative dislocation rates of hip prosthesis in these three groups of patients were compared.Results The dislocation rates of group A,B and C were 4.48%（9 cases）, 1.72% （3 cases）and 0%（0 case）.Group C had a lower postoperative dislocation rate than group A and B（P 〈0.05）.Conclusions Posterior articular capsule repair sufficiently prevents the post-THA hip dislocation,and trans-greater trochanter reconstruction of pos-terior articular capsule after pie-crusting helps the soft tissue of hip joints to restore balance,reduces the chances of suture failure in-duced by postoperative aculsion fracture of greater trochanter,which plays an active part in preventing postoperative dislocation of hip prosthesis of osteoporotic patients.

关 键 词：关节成形术 置换 髋/方法 骨质疏松 再手术 

分 类 号：R687.4[医药卫生—骨科学]