PDF(Pubmed)
Abstract：
Amputation secondary to vascular complications of recurrent dislocations after total hip arthroplasty (THA) is an extremely rare. We describe an unusual case of above-knee amputation resulting from vascular complications after recurrent dislocations of a THA. A 63-year-old male patient with walking pain and limp has a history of acetabular fracture and central dislocation of the femoral head. He was diagnosed as post-traumatic arthritis and subluxation of the femoral head and suffered from four similar dislocations in 210 days after the THA. The patient received conservative treatment after every hip dislocation. However, four months after the fourth reduction, the emergent femoral artery and popliteal artery exploration and catheter thrombectomy were performed at another hospital. An ipsilateral above-knee amputation was done after sepsis and failure of the revascularization procedure. Clinicians should be cognizant that above-knee amputation resulting from vascular complications after recurrent dislocations of a THA may occur. The lack of adherence to critical treatment may have led to the severe outcome of amputation. In conclusion, patient education and compliance are essential for both the treatment of hip dislocations and arterial occlusion. More active and effective measures should be used to prevent such catastrophic events.
摘要：
全髋关节置换术（THA）后复发性脱位继发血管并发症的截肢极为罕见。我们描述了THA复发性脱位后血管并发症导致的膝盖以上截肢的不寻常情况。一名63岁的男性患者行走疼痛和跛行，有髋臼骨折和股骨头中央脱位的病史。他被诊断为创伤后关节炎和股骨头半脱位，并在THA后210天内遭受了四次类似的脱位。患者每次髋关节脱位后均接受保守治疗。然而,第四次减少后四个月，在另一家医院进行了急诊股动脉和pop动脉探查和导管血栓切除术。败血症和血运重建失败后，进行了同侧膝上截肢。临床医生应认识到，THA复发性脱位后可能会发生血管并发症导致的膝盖以上截肢。缺乏对关键治疗的坚持可能导致严重的截肢结果。总之,患者的教育和依从性对于髋关节脱位和动脉闭塞的治疗至关重要。应该采取更加积极和有效的措施来防止此类灾难性事件。
