Lower rates of dislocation with increased femoral head size after primary total hip replacement A FIVE-YEAR ANALYSIS OF NHS PATIENTS IN ENGLAND
Lower rates of dislocation with increased femoral head size after primary total hip replacement A FIVE-YEAR ANALYSIS OF NHS PATIENTS IN ENGLAND
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DOI：
10.1302/0301-620x.93b7.26657
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发表时间：
2011-07-01
影响因子：
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通讯作者：
Reed, M. R.
中科院分区：
文献类型：
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作者：
Jameson, S. S.;Lees, D.;Reed, M. R.
增大股骨头尺寸可降低全髋关节置换术后的脱位率。英格兰和威尔士国家关节登记中心强调，直径≥ 36 mm股骨头的使用从2005年的5%增加到2009年的26%，具有统计学显著性，同时后路手术的使用也增加。这项研究的目的是确定同期脱位率是否下降。分析了英格兰247546例手术的国家数据，以确定在此期间手术后3个月、6个月、12个月和18个月的脱位率趋势。18个月的翻修率也进行了检查，在2005年至2009年期间，3个月的累积脱位率显著下降（1.12%至0.86%），6个月（1.25%至0.96%）和12个月（1.42%至1.11%）（所有p < 0.001），以及2005年至2008年期间的18个月（1.56%至1.31%）（p < 0.001）。在研究期间，18个月翻修率没有显著变化（1.26%至1.39%，比值比1.10（95%置信区间0.98至1.24），p = 0.118）。在此期间，没有证据表明脱位编码发生了变化，这些数据显示与使用大号股骨头相关的脱位显著减少，18个月翻修率没有变化。
Increased femoral head size may reduce dislocation rates following total hip replacement. The National Joint Registry for England and Wales has highlighted a statistically significant increase in the use of femoral heads >= 36 mm in diameter from 5% in 2005 to 26% in 2009, together with an increase in the use of the posterior approach. The aim of this study was to determine whether rates of dislocation have fallen over the same period. National data for England for 247 546 procedures were analysed in order to determine trends in the rate of dislocation at three, six, 12 and 18 months after operation during this time. The 18-month revision rates were also examined.Between 2005 and 2009 there were significant decreases in cumulative dislocations at three months (1.12% to 0.86%), six months (1.25% to 0.96%) and 12 months (1.42% to 1.11%) (all p < 0.001), and at 18 months (1.56% to 1.31%) for the period 2005 to 2008 (p < 0.001). The 18-month revision rates did not significantly change during the study period (1.26% to 1.39%, odds ratio 1.10 (95% confidence interval 0.98 to 1.24), p = 0.118). There was no evidence of changes in the coding of dislocations during this time.These data have revealed a significant reduction in dislocations associated with the use of large femoral head sizes, with no change in the 18-month revision rate.