The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement
The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement
复制标题
DOI：
10.2106/00004623-199708000-00013
复制
发表时间：
1997-08-01
影响因子：
5.3
通讯作者：
Kelley, SS
中科院分区：
文献类型：
--
作者：
Paterno, SA;Lachiewicz, PF;Kelley, SS
1983年7月至1994年1月，我们的老一位使用所谓的现代假体进行了438例初次全髋关节置换术和181例翻修全髋关节置换术。53例患者，47例初次手术和12例翻修，手术后不到两年死亡或失访，被排除在研究之外。对391例初次手术和169例翻修手术的患者进行了分析，以确定患者相关因素和手术因素以及髋臼假体位置对脱位率的影响。（6%）的560全髋关节置换术：十七391例初次手术中（每例发送4例），169次修订中（每发送9次）（p = 0.046），年龄、性别、肥胖或术前诊断变量与初次或翻修关节置换术后脱位之间无相关性。七（23%）的30例关节置换术患者有过量饮酒史，在530例关节成形术患者中，有25例（5%）没有此类病史的患者随后发生脱位。这种差异对于翻修关节成形术的患者来说是显著的（p = 0.00005），但根据现有数据，我们无法检测到初次关节成形术患者的差异（p = 0.264）。对32个脱位髋关节和32个未脱位髋关节进行了放射学分析（每组17例初次手术和15例翻修手术），根据假体类型和手术入路（但不是年龄）完全匹配。我们没有发现髋臼假体的版本或外展角（初次假体在39 - 56度范围内，翻修假体在38 - 57度范围内）与脱位风险之间存在相关性，每组32名Mp中有30名髋臼假体的外展角在30 - 50度的所谓安全范围内。
The senior one of us performed 438 primary and 181 revision total hip arthroplasties with use of so-called modern prostheses between July 1983 and January 1994, Fifty-three patients, who had had forty-seven primary procedures and twelve revisions, either died or were lost to follow-up less than two years after the operation and were excluded from the study The results for the remaining 446 patients (391 primary procedures and 169 revisions) were analyzed to determine the influence of patient-related and operative factors and the position of the acetabular component on the rate of dislocation.Dislocation occurred after thirty-two (6 per cent) of the 560 total hip arthroplasties: seventeen (4 per sent) of the 391 primary procedures and fifteen (9 per sent) of the 169 revisions (p = 0.046), There was no relationship between the variables of age, gender, obesity, or preoperative diagnosis and dislocation after either primary or revision arthroplasty. Seven (23 per cent) of the thirty arthroplasties in the patients who had a history of excessive intake of alcoholic beverages (more than 2.1 liters [seventy-two ounces] of beef or more than 0.2 liter [six ounces] of other alcoholic beverages a day) were followed by a dislocation compared with twenty-five (5 per cent) of the 530 arthroplasties in the patients who did not have such a history. This difference was significant for the patients who had had a revision arthroplasty (p = 0.00005), but with the numbers available we could not detect a difference for those who had had a primary arthroplasty (p = 0.264).Radiographic analysis was performed for thirty-two hips that had dislocated and thirty-two that had not (seventeen primary procedures and fifteen revisions in each group), matched exactly according to the type of prosthesis and the operative approach (but not age). We detected no association between either the version or the abduction angle of the acetabular component (within the range of 39 to 56 degrees for the primary prostheses and 38 to 57 degrees for the revision prostheses) and the risk of dislocation, Thirty of file thirty-two Mps in each group had an abduction angle of the acetabular component that was in the so-called safe range of 30 to 50 degrees.