全髋置换术后前脱位的评估与处理

Evaluation and treatment of anterior dislocation after total hip arthroplasty

摘要:

假体脱位是全髋关节置换 (total hip arthroplasty, THA) 术后常见的并发症之一，目前仍然是关节外科医生面临的主要挑战。而在术后假体前脱位发生后，有些医师甚至会错误地判断为后脱位，在闭合复位时牵引及复位方向错误，导致手法复位失败，甚至出现假体周围骨折、假体松动，需要翻修手术的可能。本文从假体前脱位的影像评估、影响因素、正确的术前规划以及术后良好的体位管理方面进行讲述，以期为指导临床医师提高患者 THA 术后疗效提供参考。

Abstract:

Dislocation of prosthesis is one of the common complications after total hip replacement, and still a major challenge for sur- geons. After the anterior dislocation of the prosthesis occurs, some doctors may even misjudge the posterior dislocation. In the closed reduc- tion process, the wrong direction of traction and reduction leads to the failure of manual reduction, even the fracture around the prosthesis and loosening of the prosthesis, with possibility of needing revision surgery. This article discusses the imaging evaluation, influencing fac- tors, correct preoperative planning and good postural management for anterior dislocation in order to provide references for clinical doctors to improve the curative outcomes of THA.