Effect of femoral head size and abductors on dislocation after revision THA
Effect of femoral head size and abductors on dislocation after revision THA
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DOI：
10.1097/blo.0b013e318159a983
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发表时间：
2007-12-01
影响因子：
4.2
通讯作者：
Ries, Michael D.
中科院分区：
文献类型：
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作者：
Kung, Peter L.;Ries, Michael D.
脱位是翻修全髋关节置换术后常见的并发症，特别是当外展机制不足时。使用大股骨头可以减少脱位的发生。然而，当外展肌机制不足时，大股骨头是否能有效控制脱位尚不清楚。我们将230例接受翻修全髋关节置换术的患者分为四组：第1组（159例）外展机制完整，28毫米股骨头；第2组（20例）外展机制缺失（转子不连或完整节段性股骨近端骨丢失），28毫米股骨头；第3组（42例）外展机制完整，36毫米股骨头；第4组（9例）外展机制缺失，36毫米股骨头。最小随访时间为6个月（平均27个月，范围6个月至7年）。改良全髋关节置换术后，36mm头的脱位率低于28 mm头且外展肌机制完整的脱位率；脱位率1组12.7%，2组40.0%，3组0%，4组33.3%。然而，如果没有外展肌机制，使用大直径头并不能降低脱位率。
Dislocation is a common complication after revision total hip arthroplasty, particularly if the abductor mechanism is deficient. Use of a large femoral head may reduce the incidence of dislocation. However, it is not clear if the large femoral head is effective in controlling dislocation when the abductor mechanism is deficient. We separated 230 patients who underwent revision total hip arthroplasty into four groups: Group 1 (159 patients) had an intact abductor mechanism and a 28-mm femoral head, Group 2 (20 patients) had an absent abductor mechanism (trochanteric nonunion or complete segmental proximal femoral bone loss) and a 28-mm femoral head, Group 3 (42 patients) had an intact abductor mechanism and a 36-mm femoral head, and Group 4 (nine patients) had an absent abductor mechanism and a 36-mm femoral head. The minimum followup was 6 months (mean, 27 months, range, 6 months to 7 years). A 36-mm head was associated with a lower dislocation rate after revision total hip arthroplasty than a 28-mm head with an intact abductor mechanism; the rate of dislocation was 12.7% for Group 1, 40.0% for Group 2, 0% for Group 3, and 33.3% for Group 4. However, the use of a large-diameter head does not reduce the rate of dislocation if the abductor mechanism is absent.