Relationship between artificial hip replacement dislocation and anterolateral approach in repairing hip joint capsule

doi:10.3969/j.issn.2095-4344.2015.44.007

Abstract

Abstract:

BACKGROUND: Studies have shown that anterolateral approach for repairing the hip joint capsule has great effects on dislocation after hip replacement, but it remains unclear at present.

OBJECTIVE: To study the impact of anterolateral approach for repairing the hip joint capsule on dislocation after artificial hip joint replacement.

METHODS: 480 patients, who received artificial hip joint replacement in the First People’s Hospital of Qinzhou from January 2010 to January 2014, were enrolled in this study. They were divided into the control group (January 2010 to January 2012) and the observation group (February 2012 to January 2014) according to the order of their admission, each of 240 cases. The control group was subdivided into the total hip replacement group (A₁ group) and the femoral head replacement group (A₂ group), each of 120 cases; and the observation group was also subdivided into the total hip replacement group (B₁group) and the femoral head replacement group (B₂ group), each of 120 cases. A₁group and A₂ group were subjected to artificial hip joint replacement via anterolateral approach. B₁ group and B₂ group were subjected to artificial hip joint replacement via anterolateral approach and the repair of the joint capsule. The postoperative early dislocation rate was analyzed in patients of A₁ group and B₁ group. Postoperative early dislocation rate was analyzed in patients of A₂ group and B₂ group.

RESULTS AND CONCLUSION: The rate of early postoperative dislocation was 6.7% in A₁ group, and 0.8% in the B₁ group. The rate of early postoperative dislocation was significantly higher in the A₁group than in the B₁ group (P < 0.05). The rate of early postoperative dislocation was 3.3% in the A₂ group and 0.8% in the B₂ group. No significant difference was found between the A₂ and B₂ groups (P > 0.05). Results showed that anterolateral approach in repairing the hip joint capsule can effectively reduce the incidence of postoperative dislocation after the total hip replacement, but does not obviously impact postoperative dislocation.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Hip, Joint Capsule, Hip Dislocation, Tissue Engineering

Lao Shi-gao, Luo Ren, Meng Zhi-jian, Li Xu, Qiu Hong-sheng, Wei Zhen-fei. Relationship between artificial hip replacement dislocation and anterolateral approach in repairing hip joint capsule[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(44): 7087-7091.

Figures/Tables 5

References

[1] 林奇益,李玉茂,谢晓勇,等.预防人工全髋关节置换早期后脱位：修复后关节囊及外旋肌群的意义[J].中国组织工程研究,2014, 18(40):6403-6407.

[2] 程旭,冯文玲,韩宗其.预防全髋关节置换术早期后脱位的临床研究[J].现代中西医结合杂志,2014,23(13):1430-1432.

[3] 刘晓宇,马胡晶,张君哲,等.关节囊修补对老年初次全髋关节置换术后早期脱位的影响[J].中国骨与关节外科,2009,2(3): 215-218.

[4] 曹学伟,肖春生,吕燃,等.三种不同方法重建髋关节后关节囊防止髋关节置换术后脱位的比较研究[J].中国矫形外科杂志,2012, 20(7):650-651.

[5] 高晓健,范国勋.全髋关节置换术后脱位的治疗[J].中国医药指南, 2011,9(24):300-302.

[6] 江渟,李业奎,张家宏.全髋关节置换术治疗股骨颈骨折中两种重建关节囊方式的比较[J].骨科,2014,5(2):84-87.

[7] 田敏,崔存宝,王东辰,等.老年股骨颈骨折人工髋关节置换67例临床报告[J].中国矫形外科杂志,2014,22(14):1325-1327.

[8] 刘博,苏祎,李彦仓,等.陈旧性髋关节脱位人工髋关节置换术后并发假性动脉瘤破裂1例[J].广东医学,2013,34(20):3198.

[9] 周园东,朱勇军,王信,等.大直径球头-骨水泥型人工髋关节置换治疗帕金森患者股骨颈骨折12例[J].激光杂志,2012,33(1): 76-77.

[10] 李远景,张德,丘宏伟,等.人工关节联合调整前倾角治疗髋关节发育不良[J].广东医学,2012,33(20):3129-3130.

[11] Kumar V, Sharma S, James J, et al. Total hip replacement through a posterior approach using a 22 mm diameter femoral head : the role of the transverse acetabular ligament and capsular repair in reducing the rate of dislocation. Bone Joint J. 2014;96-B(9):1202-1206.

[12] Langlois J, Nich C, Courpied JP, et al.An unreported cause of early postoperative dislocation following total hip revision: massive intra-capsular oedema related to inferior vena cava filter thrombosis. Orthop Traumatol Surg Res. 2013;99(3): 367-370.

[13] Brown TD, Elkins JM, Pedersen DR, et al. Impingement and dislocation in total hip arthroplasty: mechanisms and consequences. Iowa Orthop J.2014;34:1-15.

[14] Browne JA, Pagnano MW. Surgical technique: a simple soft-tissue-only repair of the capsule and external rotators in posterior-approach THA. Clin Orthop Relat Res. 2012;470(2): 511-515.

[15] Van Warmerdam JM, McGann WA, Donnelly JR, et al. Achilles allograft reconstruction for recurrent dislocation in total hip arthroplasty. J Arthroplasty. 2011;26(6):941-948.

[16] Wang G, Gu GS, Li D, et al. Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients. Chin J Traumatol. 2010;13(4):234-239.

[17] Henderson ER, Jennings JM, Marulanda GA, et al. Purse-string capsule repair to reduce proximal femoral arthroplasty dislocation for tumor--a novel technique with results. J Arthroplasty. 2010;25(4):654-657.

[18] Hummel MT, Malkani AL, Yakkanti MR,et al. Decreased dislocation after revision total hip arthroplasty using larger femoral head size and posterior capsular repair. J Arthroplasty. 2009;24(6 Suppl):73-76.

[19] Tsai SJ, Wang CT, Jiang CC. The effect of posterior capsule repair upon post-operative hip dislocation following primary totalhip arthroplasty.BMC Musculoskelet Disord. 2008;9:29.

[20] Jab?oński M, Gorzelak M, Kuczyński P, et al. Less invasive posterior surgical approach for hip joint replacement-- complications and limitations. Ortop Traumatol Rehabil.2007; 9(1):25-30.

[21] 于杰,范少地,王仁,等.人工髋关节翻修21例临床分析[J]. 实用医学杂志,2011,27(2):275-277.

[22] Prietzel T, Hammer N, Schleifenbaum S, et al.The impact of capsular repair on the dislocation rate after primary total hip arthroplasty: a retrospective analysis of 1972 cases. Z Orthop Unfall.2014;152(2):130-143.

[23] 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.

[24] Shen P, Xu N, Jiang F, et al. Impact of joint capsule repair and external rotators suture on prognosis in primary total hip arthroplasty by posterolateral approach. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi.2012;26(11):1300-1305.

[25] 宋伟毅,刘忠堂,王兵,等.髋关节置换术治疗老年偏瘫侧股骨颈骨折[J]. 中国矫形外科杂志,2012,16(10):942-943.

[26] 刘金钊,姜宁,高鹏,等. 全髋关节置换关节囊修复对预后功能的影响[J]. 中国骨与关节杂志,2014,3(6):414-418.

[27] 吴庆光,周立平.髋关节后外侧入路的改良方式[J].医药前沿, 2013,1(14):10-11.

[28] Musil D, Stehlík J.[Minimally invasive anterolateral surgical approach for total hip arthroplasty: seven-year results]. Acta Chir Orthop Traumatol Cech. 2013;80(2):138-141.

[29] Sasaki M, Nagoya S, Kaya M, et al. Relationship between the hip joint capsule and piriformis tendon in a simulation of the modified Watson-Jones anterolateral approach in THA cadaver study. Clin Anat. 2013;26(5):610-613.

[30] Roth A, Venbrocks RA. Total hip replacement through a minimally invasive, anterolateral approach with the patient supine. Oper Orthop Traumatol. 2007;19(5-6):442-457.