Abstract:
Total hip arthroplasty (THA) is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease. However, dislocation continues to be a troublesome complication after THA, as it is a leading cause of revision and is associated with substantial social, health, and economic costs. It is a relatively rare, usually early occurrence that depends on both the patients\' characteristics and the surgical aspects. The most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility, which is closely related to the incidence of dislocation. Consequently, clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the cup. Lumbar spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after THA. Surgical options for its treatment and prevention include the use of prostheses with large diameter of femoral head size, dual mobility constructs, constrained liners, and modular neck stems.
摘要:
全髋关节置换术(THA)是骨科手术中最成功的选择性手术之一,可改善终末期关节疾病患者的疼痛和功能障碍。然而,脱位仍然是THA后一个麻烦的并发症,因为它是修订的主要原因,并且与实质性的社会联系在一起,健康,和经济成本。这是一个相对罕见的,通常是早期发生,这取决于患者的特征和手术方面。最近和最重要的发现是术前特别注意脊柱肾盂活动,这与位错的发生密切相关。因此,必须对腰椎进行临床和影像学评估,以确定骨盆倾斜的改变,这可能表明杯子的不同位置。腰椎融合术目前被认为是脱位和翻修的危险因素,无论它是在THA之前还是之后进行。其治疗和预防的手术选择包括使用大直径股骨头大小的假体,双迁移率结构,约束衬垫,和模块化的颈部茎。