Analysis and Prevention of Prosthesis Dislocation after Primary Artificial Hip Replacement_West China Medical Journal

Authors：

 FANGui-fu , LUOYong , XUXiang-wei , LIANGYi , LIUHong

Department of Orthopedics, Downtown People's Hospital of Neijiang City, Neijiang, Sichuan 641000, P. R. China;

Corresponding author：

Keywords：

Artificial hip; Replacement; Dislocation; Causes; Prevention

DOI：

10.7507/1002-0179.20140007

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Objective To explore the cause of prosthesis dislocation after primary artificial hip replacement (AHR) and propose preventive measures. Methods A total of 221 patients underwent artificial hip replacement from 2000 to 2012, among whom 8 developed dislocation. These cases were retrospectively analyzed to summarize the causes of dislocation and preventive measures were proposed. Results Among 221 cases of hip replacement, 8 suffered from postoperative dislocation. All of them underwent posterolateral-approach total hip arthroplasty. The causes of dislocation included coexisting decreased muscle strength before operation, improper placement of the prosthesis during operation, inappropriate postural changes after operation, improper nursing and health education. Of the 8 dislocation cases, 2 were cured after reoperation and revision, 6 were cured through close reduction under anesthesia, and 7 were followed up for 1-5 years without relapse. Conclusion Preoperative assessment of the patients' soft tissue tension of affected hip and comorbid conditions, selection of proper design of prostheses and the components, removal of tissues possibly causing joint impact, correct placement of artificial prosthesis and components and instructing the patients for the correct movement mode of the affected hip after operation are all crucial for the prevention of postoperative hip dislocation.

Citation： FANGui-fu, LUOYong, XUXiang-wei, LIANGYi, LIUHong. Analysis and Prevention of Prosthesis Dislocation after Primary Artificial Hip Replacement. West China Medical Journal, 2014, 29(1): 23-25. doi: 10.7507/1002-0179.20140007 Copy

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11.	Newington DP, Bannister GC, Fordyce M. Primary total hip replacement in patients over 80 years of age[J]. J Bone Joint Surg (Br), 1990, 72-B(3):450-452.
12.	Woo RY, Morrey BF. Dislocations after total hip arthroplasty[J]. J Bone Joint Surg (Am), 1982, 64(9):1295-1306.
13.	Biedermann R, Tonin A, Krismer M, et al. Reducing the risk of dislocation after total hip arthroplasty:the effect of orientation of the acetabular component[J]. J Bone Joint Surg (Br), 2005, 87(6):762-769.
14.	熊涛. 人工髋关节置换手术并发症分析[J]. 华西医学, 2006, 21(4):755-756.
15.	焦建, 范树枫, 刘元禄. 人工髋关节翻修术15例临床分析[J]. 中医正骨, 2006, 18(3):48-49.
16.	徐杨博, 尚庆, 葛建华. 高龄全髋关节置换术后脱位的防治[J]. 中国骨与关节损伤杂志, 2008, 23(10):865-866.
17.	李凤朝, 李子荣. 髋关节置换术后假体脱位的防治[J]. 中国矫形外科杂志, 2009, 17(9):674-676.
18.	孙宁, 郝云甲, 王佳音, 等. 高龄人工髋关节置换术后脱位的原因及处理对策[J]. 中国老年学杂志, 2013, 33(5):1185-1186.
19.	杨文婷, 雷寿斌, 张晓琼. 髋关节置换围手术期护理与康复[J]. 按摩与康复医学, 2011, 2(11):124.
20.	张志, 张飞, 张宵雁. 全髋关节置换术后脱位的原因分析及防治[J]. 中国现代医学杂志, 2012, 22(1):94-96.

1. 黄炎,孔荣, 方诗元, 等. 人工全髋关节置换术后脱位的原因分析和防治对策[J]. 中国矫形外科杂志, 2009, 17(5):333-335.
2. 杜江, 于晨, 井耀华. 老年患者人工髋关节置换术后并发症分析[J]. 医药前沿, 2013(1):191-192.
3. 梅汉尧, 索鹏, 周永顶, 等. 初次人工髋关节置换术后感染的诊断与治疗[J]. 实用骨科杂志, 2006, 12(4):298-299.
4. Blom AW, Rogers M, Taylor AH, et al. Dislocation following total hip replacement:the Avon Orthopaedic Centre experience[J]. Ann R Coll Surg Engl, 2008, 90(8):658-662.
5. Parvizi J, Picinic E, Sharkey PF. Revision total hip arthroplasty for instability:surgical techniques and principles[J]. J Bone Joint Surg Am, 2008, 90(5):1134-1142.
6. 吴义龙, 梁国伟, 杨景芳, 等. 人工髋关节置换术后早期脱位原因探讨及预防[J]. 实用骨科杂志, 2007, 13(8):479-480.
7. 吕厚山. 现代人工关节外科学[M]. 北京:人民卫生出版社, 2006:599.
8. 苏冰梅, 苏冰莲, 谭富海. 全髋关节置换术后髋关节脱位的危险因素分析及护理对策[J]. 中国实用护理杂志, 2012, 28(21):39-40.
9. 张连英, 姜世平. 髋关节置换术后假体脱位原因分析及护理[J]. 实用临床医学, 2011, 12(1):116-117.
10. 唐相君, 罗娟. 人工髋关节置换术后脱位的风险因素及护理干预[J]. 四川医学, 2011, 32(5):788-790.
11. Newington DP, Bannister GC, Fordyce M. Primary total hip replacement in patients over 80 years of age[J]. J Bone Joint Surg (Br), 1990, 72-B(3):450-452.
12. Woo RY, Morrey BF. Dislocations after total hip arthroplasty[J]. J Bone Joint Surg (Am), 1982, 64(9):1295-1306.
13. Biedermann R, Tonin A, Krismer M, et al. Reducing the risk of dislocation after total hip arthroplasty:the effect of orientation of the acetabular component[J]. J Bone Joint Surg (Br), 2005, 87(6):762-769.
14. 熊涛. 人工髋关节置换手术并发症分析[J]. 华西医学, 2006, 21(4):755-756.
15. 焦建, 范树枫, 刘元禄. 人工髋关节翻修术15例临床分析[J]. 中医正骨, 2006, 18(3):48-49.
16. 徐杨博, 尚庆, 葛建华. 高龄全髋关节置换术后脱位的防治[J]. 中国骨与关节损伤杂志, 2008, 23(10):865-866.
17. 李凤朝, 李子荣. 髋关节置换术后假体脱位的防治[J]. 中国矫形外科杂志, 2009, 17(9):674-676.
18. 孙宁, 郝云甲, 王佳音, 等. 高龄人工髋关节置换术后脱位的原因及处理对策[J]. 中国老年学杂志, 2013, 33(5):1185-1186.
19. 杨文婷, 雷寿斌, 张晓琼. 髋关节置换围手术期护理与康复[J]. 按摩与康复医学, 2011, 2(11):124.
20. 张志, 张飞, 张宵雁. 全髋关节置换术后脱位的原因分析及防治[J]. 中国现代医学杂志, 2012, 22(1):94-96.

West China Medical Journal

Analysis and Prevention of Prosthesis Dislocation after Primary Artificial Hip Replacement

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