Dislocation after total hip arthroplasty
- VernacularTitle:髋关节置换后不稳定的相关研究现状
- Author:
Songjie JI
;
Yixin ZHOU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;0(13):-
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Total hip replacement is frequently used for osteoarthritis, rheumatoid arthritis, avascular necrosis of femoral head, et al. Although the operation is effective, some complications such as dislocation are serious and arouse more attention. OBJECTIVE: To review the research status of dislocation after total hip arthroplasty. RETRIEVAL STRATEGY: A computer-based online search of PubMed was undertaken for the English articles published between January 1997 and November 2007 with"hip replacement, dislocation". 496 related articles were collected from the above-mentioned database, including 445 original articles, and 57 review articles. Only articles ①about the influential factors for dislocation of hip joint; ②about the prevention and treatment of dislocation; ③highly correlated with the objective; and ④ published in recently or in authoritative journals were selected. Repetitive studies and Meta analyses were excluded. LITERATURE EVALUATION: Thirty-five articles were included, of which 9 were review articles and the others were clinical or empirical studies. DATA SYNTHESIS: ①Posterolateral approach in total hip arthroplasty increases the dislocation rate compared to anterior lateral approach and direct lateral approach. But when posterior articular capsule and extortor are sutured using absorbable thread before wound suture in total hip arthroplasty by posterolateral approach, the dislocation rate is increased and similar to anterior lateral approach and direct lateral approach. ②Large ball head of prosthesis can decrease the incidence of dislocation. In addition, the incidence of dislocation in prosthesis with skirted is less than prosthesis with no skirt. Elevated-rim acetabular liner can decrease but small offset distance can increase incidence of dislocation. ③Close reduction can cure early dislocation. If the dislocation is caused by infection, it is necessary to clear the wound, even take out the prosthesis for revision. Prosthesis location should be adjusted and hip joint with unbalance soft tissue should be treated by another surgery. ④If patients with recurrent dislocation, weak abductor, obvious soft tissue unbalance or other reason, it is better to use constrained prosthesis. CONCLUSION: Dislocation after total hip arthroplasty is caused by lots of complicated factors. With the acquaintance of factors and development of surgery techniques, the dislocation rate is significantly reduced than before. Complicated dislocation caused by soft tissue unbalance is the focus of future research.
