赖然, 英强, 舒克冬, 敬东. 骨性关节炎全髋关节置换术术后脱位发生情况及其影响因素研究[J]. 蚌埠医科大学学报, 2019, 44(9): 1240-1243. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.027
    引用本文: 赖然, 英强, 舒克冬, 敬东. 骨性关节炎全髋关节置换术术后脱位发生情况及其影响因素研究[J]. 蚌埠医科大学学报, 2019, 44(9): 1240-1243. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.027
    LAI Ran, YING Qiang, SHU Ke-dong, JING Dong. Study on the occurrence of postoperative dislocation of total hip arthroplasty in patients with osteoarthritis, and its multivariate analysis[J]. Journal of Bengbu Medical University, 2019, 44(9): 1240-1243. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.027
    Citation: LAI Ran, YING Qiang, SHU Ke-dong, JING Dong. Study on the occurrence of postoperative dislocation of total hip arthroplasty in patients with osteoarthritis, and its multivariate analysis[J]. Journal of Bengbu Medical University, 2019, 44(9): 1240-1243. DOI: 10.13898/j.cnki.issn.1000-2200.2019.09.027

    骨性关节炎全髋关节置换术术后脱位发生情况及其影响因素研究

    Study on the occurrence of postoperative dislocation of total hip arthroplasty in patients with osteoarthritis, and its multivariate analysis

    • 摘要:
      目的研究骨性关节炎全髋关节置换术(total hip arthroplasty,THA)术后脱位发生情况及其危险因素分析。
      方法选取266例骨性关节炎病人,均采用THA治疗,术后随访6个月,记录髋关节脱位发生情况,将术后髋关节脱位病人设为脱位组,未脱位病人设为未脱位组。记录2组病人手术相关指标及病历资料,经单因素分析、logistic回归分析探讨骨性关节炎THA术后脱位的独立危险因素。
      结果266例骨性关节炎病人THA术后脱位25例,脱位率9.40%;2组病人年龄、人工股骨头直径、髋关节手术史、手术失血量、术后股骨假体前倾角、术后股骨偏心距差异有统计学意义(P < 0.05~P < 0.01),而性别、BMI、手术入路、合并糖尿病、手术时间、术后输血率、术后引流量、手术侧别差异无统计学意义(P>0.05)。多因素logistic回归分析显示,年龄>75岁、女性、人工股骨头直径 < 30 mm、髋关节手术史、后外侧入路、术后股骨假体前倾角>10°是骨性关节炎THA术后脱位的独立危险因素(P < 0.05)。
      结论骨性关节炎THA术后容易发生髋关节脱位,年龄>75岁、女性、人工股骨头直径 < 30 mm、髋关节手术史、后外侧入路均可增加其脱位风险。

       

      Abstract:
      ObjectiveTo study the occurrence and risk factors of dislocation after total hip arthroplasty(THA) for osteoarthritis.
      MethodsA total of 266 patients with osteoarthritis were treated with THA, and followed up for 6 months.The occurrence of dislocation of the hip joint was recorded.The patients with postoperative dislocation of the hip joint were set as the dislocation group, and the patients without dislocation were set as undislocation group.The surgical indicators and medical record in two groups were analyzed using univariate and logistic regression analysis to explore the independent risk factors of postoperative dislocation in patients treated with THA.
      ResultsAmong 266 patients with osteoarthritis, 25 cases with dislocation after THA were found, and the dislocation rate was 9.40%.The differences of the age, artificial femoral head diameter, history of hip surgery, postoperative blood loss, anterior angle of femoral prosthesis and postoperative femoral eccentricity between two groups were statistically significant(P < 0.05 to P < 0.01), and the differences of the gender, body mass index, surgical approach, combined diabetes mellitus, operative time, postoperative transfusion rate, postoperative drainage volume and operative side between two groups were not statistically significant(P>0.05).The results of multivariate logistic regression analysis showed that age >75 years, female, diameter of artificial femoral head < 30 mm, history of hip surgery, posterolateral approach and anteversion of femoral prosthesis >10° were the independent risk factors of dislocation after aosteoarthritis treated with THA(P < 0.05).
      ConclusionsThe hip joint with osteoarthritis is prone to dislocation after THA, the age >75 years, female, artificial femoral head diameter < 30 mm, hip surgery history and posterior lateral approach can increase the risk of dislocation.

       

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