髋关节置换后不稳定的相关研究现状.docVIP

髋关节置换后不稳定的相关研究现状 及松洁，周一新 Dislocation after total hip arthroplasty Ji Song-jie, Zhou Yi-xin Abstract BACKGROUND: Total hip replacement is frequently used for osteoarthritis, rheumatoid arthritis, avascular necrosis of femoral head, et al. Although the operation is effective, some complications such as dislocation are serious and arouse more attention. OBJECTIVE: To review the research status of dislocation after total hip arthroplasty. RETRIEVAL STRATEGY: A computer-based online search of PubMed was undertaken for the English articles published between January 1997 and November 2007 with keywords “hip replacement, dislocation”. 496 related articles were collected from the above-mentioned database, including 445 original articles, and 57 review articles. Only articles ①about the influential factors for dislocation of hip joint; ②about the prevention and treatment of dislocation; ③highly correlated with the objective; and ④published in recently or in authoritative journals were selected. Repetitive studies and Meta analyses were excluded. LITERATURE EVALUATION: Thirty-five articles were included, of which 9 were review articles and the others were clinical or empirical studies. DATA SYNTHESIS: ①Posterolateral approach in total hip arthroplasty increases the dislocation rate compared to anterior lateral approach and direct lateral approach. But when posterior articular capsule and extortor are sutured using absorbable thread before wound suture in total hip arthroplasty by posterolateral approach, the dislocation rate is increased and similar to anterior lateral approach and direct lateral approach. ②Large ball head of prosthesis can decrease the incidence of dislocation. In addition, the incidence of dislocation in prosthesis with skirted is less than prosthesis with no skirt. Elevated-rim acetabular liner can decrease but small offset distance can increase incidence of dislocation. ③Close reduction can cure early dislocation. If the dislocation is caused by infection