初次全髋关节置换术后脱位的预防

来源：304关节学术

Prevention of Dislocation After Total Hip Arthroplasty

初次全髋关节置换术后脱位的预防

译者：张峻

Background: Prevention of dislocation after primary total hip arthroplasty (THA) begins with patient preoperative assessment and planning.

背景：初次全髋关节置换术（THA）术后脱位的预防应该始于患者术前评估和术前计划。

Methods: We performed a literature search to assess historical perspectives and current strategies to prevent dislocation after primary THA. The search yielded 3458 articles, and 154 articles are presented.

方法：我们进行了一个文献检索，以评估防止初次THA术后脱位历史观点和目前的策略。搜索结果为3458篇文章，列出了154篇文章。

Results: Extremes of age, body mass index >30 kg/m2, lumbosacral pathology, surgeon experience, and femoral head size influence dislocation rates after THA. There is mixed evidence regarding the effect of neuromuscular disease, sequelae of pediatric hip conditions, and surgical approach on THA instability. Sex, simultaneous bilateral THA, and restrictive postoperative precautions do not influence the dislocation rates of THA. Navigation, robotics, lipped liners, and dual-mobility acetabular components may improve dislocation rates.

结果：高龄、BMI>30kg/m²、腰骶部疾病、外科医生经验和股骨头大小影响全髋关节置换术后脱位率。关于神经肌肉疾病、儿童髋关节疾病后遗症和手术入路对THA不稳定的影响有多种证据。性别、双侧同时THA、术后严格预防措施对THA脱位率无影响。导航、机器人技术、唇形衬垫和双动髋臼假体可能会改善脱位率。

Conclusions: Risks for dislocation should be identified, and measures should be taken to mitigate the risk. Reliance on safe zones of acetabular component positioning is historical. We are in an era of bespoke THA surgery.

结论：应重视确脱位的风险，并采取措施降低风险。依赖于“安全区”对髋臼假体定位已经过时了。我们正处在一个定制THA手术的时代。

文献出处：Rowan FE, Benjamin B, Pietrak JR, Haddad FS. Prevention of Dislocation After Total Hip Arthroplasty. J Arthroplasty. 2018 May;33(5):1316-1324. doi: 10.1016/j.arth.2018.01.047. Epub 2018 Mar 7. PMID: 29525344.