修复关节囊及外旋肌群对预防全髋关节置换术后关节脱位的作用

目的 探讨采用髋关节后外侧切口进行初次全髋关节置换术(THA)时修复关节囊及外旋肌的作用.方法 2002年1月至2006年6月,初次采用后外侧切口行THA 116例122髋,术中保留后方关节囊及外旋肌群,并且分别将其用疝缝线"8"字直接缝合至股骨大转子(修复组).将修复组THA术后脱位率与同期常规行THA(未修复关节囊及外旋肌,对照组)的255例266髋THA做比较分析. 结果术后6个月内,修复组仅1髋(1/122,0.8%)发生术后早期脱位;对照组则有15髋发生早期脱位(15/266,5.6%),早期脱位率差异有统计学意义(X2=4.914,P=0.027);两组术后6个月均无冉脱位. 结论采用后外侧切口进行THA时修复关节囊及外旋肌群技术能够有效预防术后早期脱位.

Effect of repairing capsule and short external rotators on postoperative dislocation rate following pri-mary total hip arthroplasty

Objective To explore the effect of repairing capsule and short external rotators by postero-lateral approach on postoperative dislocation rate following primary total hip arthroplasty. Methods We retrospectively analyzed the 371 cases of primary THA (388 hips) performed through posterolateral approach in our hospital from January 2002 to June 2006. Of them, 116 cases (122 hips) received repair of the posterior capsule and short external rotators which were sutured in figure-of-8 respectively to the greater trechanter of the femur. The postoperative dislocation rate of this group was compared with that of the other 255 eases of routine THA (266 hips) without posterior capsulotendinous repair. There were no significant differences in the mean age, gender, complicated diseases and duration of follow-up between the 2 groups ( P ＞ 0.05).Results In patients with posterior eapsulotendinous repair, only 1 dislocation occurred within 6 months after primary THA (0.8% ); while in patients without posterior capsulotendinous repair, 15 dislocations oc-curred (5.6%). The difference between the 2 groups was statistically significant ( P = 0.027). There was no significant difference in the dislocation rate beyond 6 months between the 2 groups. Conclusion Repair of posterior capsule and short external rotators can effectively prevent early dislocation after primary THA.