Causes and managements of dislocation after total hip arthroplasty
- VernacularTitle:全髋关节置换术后脱位的原因分析及处理
- Author:
Hua TIAN
;
Ke ZHANG
;
Yan LIU
- Publication Type:Journal Article
- Keywords:
hip joint;
total hip arthroplasty;
postoperation;
dislocation
- From:
Orthopedic Journal of China
2006;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective] To approach the causes and managements of dislocation after total hip arthroplasty.[Methods]850 total hip arthroplasties were done in our department from 1996 to 2004,in which 7 cases experienced post-operative dislocation.Whith 4 males and 3 females,the average age was 67 years old.Causes and managements have been studied retrospectively through analysis of history,surgical approach,timing and direction of the dislocations and predisposing factors of the dislocations occurred.[Results]There wer 7 cases of dislocations of which 5 patients(71%)were primary cases and 2 patients(29%)were revision cases;4 patients(57%)had history of hip surgery;1 case had mental disorder after cerebral surgery.Direct lateral approach was used for all these patients,and only anterior dislocation was occurred in this group.Through study the AP X-rays postoperatively,the abduction angle were more than 55 degree in 2 of these cases.The time of dislocation was from right after operation to 27 months after operation;5 of them experienced their dislocation within 3 months after operation.Closed reduction and 6 weeks traction were selected for all these patients,and 6 of them were successful.Recurrent dislccation occurred twice in another one patient within 3 months after reduction,and the acetabular cup was loosened during closed reduction.A stable joint was achieved after revision and modifying the abduction angle of the cup.[Conclusion]Causative risk factors for dislocation after total hip arthroplasty include surgery history on the same hip,inability to comply with instructions of rehabilitation,approach of surgery and malposition of the prosthesis.Closed reduction and traction for 6-week afterwards are usually successful for most of the dislocated cases.Revision could be done in the base of analyzing the reasons for recurrent dislocation,and then stale joint could be achieved.
