Analysis and Prevention of Prosthesis Dislocation after Primary Artificial Hip Replacement_West China Medical Journal

Authors：

 FANGui-fu , LUOYong , XUXiang-wei , LIANGYi , LIUHong

Department of Orthopedics, Downtown People's Hospital of Neijiang City, Neijiang, Sichuan 641000, P. R. China;

Corresponding?author：

Keywords：

Artificial hip; Replacement; Dislocation; Causes; Prevention

DOI：

10.7507/1002-0179.20140007

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Objective To explore the cause of prosthesis dislocation after primary artificial hip replacement (AHR) and propose preventive measures. Methods A total of 221 patients underwent artificial hip replacement from 2000 to 2012, among whom 8 developed dislocation. These cases were retrospectively analyzed to summarize the causes of dislocation and preventive measures were proposed. Results Among 221 cases of hip replacement, 8 suffered from postoperative dislocation. All of them underwent posterolateral-approach total hip arthroplasty. The causes of dislocation included coexisting decreased muscle strength before operation, improper placement of the prosthesis during operation, inappropriate postural changes after operation, improper nursing and health education. Of the 8 dislocation cases, 2 were cured after reoperation and revision, 6 were cured through close reduction under anesthesia, and 7 were followed up for 1-5 years without relapse. Conclusion Preoperative assessment of the patients' soft tissue tension of affected hip and comorbid conditions, selection of proper design of prostheses and the components, removal of tissues possibly causing joint impact, correct placement of artificial prosthesis and components and instructing the patients for the correct movement mode of the affected hip after operation are all crucial for the prevention of postoperative hip dislocation.

Citation： FANGui-fu, LUOYong, XUXiang-wei, LIANGYi, LIUHong. Analysis and Prevention of Prosthesis Dislocation after Primary Artificial Hip Replacement. West China Medical Journal, 2014, 29(1): 23-25. doi: 10.7507/1002-0179.20140007 Copy

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11.	Newington DP, Bannister GC, Fordyce M. Primary total hip replacement in patients over 80 years of age[J]. J Bone Joint Surg (Br), 1990, 72-B(3):450-452.
12.	Woo RY, Morrey BF. Dislocations after total hip arthroplasty[J]. J Bone Joint Surg (Am), 1982, 64(9):1295-1306.
13.	Biedermann R, Tonin A, Krismer M, et al. Reducing the risk of dislocation after total hip arthroplasty:the effect of orientation of the acetabular component[J]. J Bone Joint Surg (Br), 2005, 87(6):762-769.
14.	熊濤. 人工髖關節置換手術并發癥分析[J]. 華西醫學, 2006, 21(4):755-756.
15.	焦建, 范樹楓, 劉元祿. 人工髖關節翻修術15例臨床分析[J]. 中醫正骨, 2006, 18(3):48-49.
16.	徐楊博, 尚慶, 葛建華. 高齡全髖關節置換術后脫位的防治[J]. 中國骨與關節損傷雜志, 2008, 23(10):865-866.
17.	李鳳朝, 李子榮. 髖關節置換術后假體脫位的防治[J]. 中國矯形外科雜志, 2009, 17(9):674-676.
18.	孫寧, 郝云甲, 王佳音, 等. 高齡人工髖關節置換術后脫位的原因及處理對策[J]. 中國老年學雜志, 2013, 33(5):1185-1186.
19.	楊文婷, 雷壽斌, 張曉瓊. 髖關節置換圍手術期護理與康復[J]. 按摩與康復醫學, 2011, 2(11):124.
20.	張志, 張飛, 張宵雁. 全髖關節置換術后脫位的原因分析及防治[J]. 中國現代醫學雜志, 2012, 22(1):94-96.

1. 黃炎,孔榮, 方詩元, 等. 人工全髖關節置換術后脫位的原因分析和防治對策[J]. 中國矯形外科雜志, 2009, 17(5):333-335.
2. 杜江, 于晨, 井耀華. 老年患者人工髖關節置換術后并發癥分析[J]. 醫藥前沿, 2013(1):191-192.
3. 梅漢堯, 索鵬, 周永頂, 等. 初次人工髖關節置換術后感染的診斷與治療[J]. 實用骨科雜志, 2006, 12(4):298-299.
4. Blom AW, Rogers M, Taylor AH, et al. Dislocation following total hip replacement:the Avon Orthopaedic Centre experience[J]. Ann R Coll Surg Engl, 2008, 90(8):658-662.
5. Parvizi J, Picinic E, Sharkey PF. Revision total hip arthroplasty for instability:surgical techniques and principles[J]. J Bone Joint Surg Am, 2008, 90(5):1134-1142.
6. 吳義龍, 梁國偉, 楊景芳, 等. 人工髖關節置換術后早期脫位原因探討及預防[J]. 實用骨科雜志, 2007, 13(8):479-480.
7. 呂厚山. 現代人工關節外科學[M]. 北京:人民衛生出版社, 2006:599.
8. 蘇冰梅, 蘇冰蓮, 譚富海. 全髖關節置換術后髖關節脫位的危險因素分析及護理對策[J]. 中國實用護理雜志, 2012, 28(21):39-40.
9. 張連英, 姜世平. 髖關節置換術后假體脫位原因分析及護理[J]. 實用臨床醫學, 2011, 12(1):116-117.
10. 唐相君, 羅娟. 人工髖關節置換術后脫位的風險因素及護理干預[J]. 四川醫學, 2011, 32(5):788-790.
11. Newington DP, Bannister GC, Fordyce M. Primary total hip replacement in patients over 80 years of age[J]. J Bone Joint Surg (Br), 1990, 72-B(3):450-452.
12. Woo RY, Morrey BF. Dislocations after total hip arthroplasty[J]. J Bone Joint Surg (Am), 1982, 64(9):1295-1306.
13. Biedermann R, Tonin A, Krismer M, et al. Reducing the risk of dislocation after total hip arthroplasty:the effect of orientation of the acetabular component[J]. J Bone Joint Surg (Br), 2005, 87(6):762-769.
14. 熊濤. 人工髖關節置換手術并發癥分析[J]. 華西醫學, 2006, 21(4):755-756.
15. 焦建, 范樹楓, 劉元祿. 人工髖關節翻修術15例臨床分析[J]. 中醫正骨, 2006, 18(3):48-49.
16. 徐楊博, 尚慶, 葛建華. 高齡全髖關節置換術后脫位的防治[J]. 中國骨與關節損傷雜志, 2008, 23(10):865-866.
17. 李鳳朝, 李子榮. 髖關節置換術后假體脫位的防治[J]. 中國矯形外科雜志, 2009, 17(9):674-676.
18. 孫寧, 郝云甲, 王佳音, 等. 高齡人工髖關節置換術后脫位的原因及處理對策[J]. 中國老年學雜志, 2013, 33(5):1185-1186.
19. 楊文婷, 雷壽斌, 張曉瓊. 髖關節置換圍手術期護理與康復[J]. 按摩與康復醫學, 2011, 2(11):124.
20. 張志, 張飛, 張宵雁. 全髖關節置換術后脫位的原因分析及防治[J]. 中國現代醫學雜志, 2012, 22(1):94-96.

West China Medical Journal

Analysis and Prevention of Prosthesis Dislocation after Primary Artificial Hip Replacement

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