Fifteen cases of dislocation after total hip arthroplasty / 中国组织工程研究

ABSTRACT

AIM:To analyze the cause of hip prosthesis dislocation,so as to prevent the dislocation following total hip arthroplasty(THA).METHODS:Between January 2002 and June 2007,a total of 348 cases(406 hips) received THA in the Department of Orthopaedics,the Second Affiliated Hospital of Fujian Medical University,and 15 patients(15 hips) occurred dislocation(3.7%),including 6 males and 9 females.Their age ranged 35-76 years,with a mean of 58 years.Primary affections consisted of femoral neck fracture in 3 cases(one with dislocation rebuilding after THA),femoral necrosis in 5 cases,hip arthodysplasia in 5 cases,and osteoarthritis in 2 cases.THA was carried out through lateral approach in 8 patients,and posterior lateral approach in 7 patients.The first dislocation occurred in 2 patients within 2 weeks,3 patients during 2-4 weeks,6 patients during 4-6 weeks,3 patients during 6-12 weeks,and 1 patient 12 weeks later.The movement of dislocation occurrence includes moving the patients in 2,turning over in 2,turning around in 4,trying to stand from sitting in 3,sock wearing in 3,and picking up in 2.It was revealed in the clinical analysis and operational incision that anterior dislocation was found in 6 cases,while posterior dislocation in 9 cases;proper placement of prosthesis in 5 cases,while incorrect placement in 10 cases.Close reduction was conducted in short time after dislocation,achieving success in 11 cases.There were 4 cases treated with open reduction after failure of close reduction,and hip joints were restricted.Seven patients were found dislocation again.And four patients prolonged external fixation and 3 patients were performed revision.RESULTS:The follow-up period ranged from 10 to 60 months.Eight cases succeeded the first reduction,with good joint stability and without relapse.Redislocation occurred in 4 cases,and was cured by prolonging fixation.No cases following revision were found dislocation.The average score was(85?5) according to Harris scoring system.There was no biocompatibility between the materials and the host.CONCLUSION:We should emphasize prevention of dislocation in the early THA and enough fixation time after reduction.