摘要
背景:全髋关节置换后假体脱位是限制假体使用寿命最重要的因素之一,给患者带来巨大的身体痛苦与经济负担。研究发现,腰椎融合是全髋关节置换后假体脱位最重要的独立危险因素,探究其引发脱位的原因并提出治疗方案一直是关节外科医生关注的重要课题。目的:针对腰椎骨盆矢状面,探讨有腰椎融合手术史的患者再行全髋关节置换后假体脱位率增加的原因以及治疗方案,并作出综述。方法:中文以"腰椎融合术,全髋关节置换术,骨盆矢状面,撞击,脱位"为关键词,英文以"lumbar fusion,total hip replacement,pelvic sagittal plane,impingement,dislocation"为关键词,检索CNKI、万方、Pub Med数据库2016至2020年发表的相关文章,依据纳入及排除标准,最终纳入39篇文献。结果与结论:(1)有腰椎融合手术史的患者再行全髋关节置换后假体脱位率增加的根本原因是撞击,腰椎骨盆矢状面X射线片是研究撞击最经济有效的方式;(2)腰椎融合后,腰椎通过平衡性与活动性两方面影响骨盆矢状面,增加撞击风险:腰椎严重失衡,导致骨盆后倾,髋臼垂直,增加撞击风险;腰椎僵硬,导致骨盆活动度下降,髋关节活动度增加,增加撞击风险;(3)腰椎、骨盆与髋关节矢状面的相互关系具有广泛的应用价值。
BACKGROUND:Dislocation of the prosthesis after total hip replacement is one of the most important factors that limit the life of the prosthesis,which brings huge physical pain and economic burden to the patient.Studies have found that lumbar fusion is the most important independent risk factor for prosthesis dislocation after total hip arthroplasty.Exploring the reasons for the dislocation and proposing treatment options have always been an important topic for joint surgeons.OBJECTIVE:To analyze and review the reasons for the increased dislocation rate of the prosthesis after total hip replacement in patients with a history of lumbar fusion surgery and the treatment plan by studying the sagittal plane of the lumbar spine and pelvis.METHODS:The Chinese key words were"lumbar fusion;total hip replacement;pelvic sagittal plane;impingement;dislocation"and the English key words were"lumbar fusion;total hip replacement;pelvic sagittal plane;impingement;dislocation".After searching the articles published from 2016 to 2020 in Wanfang,CNKI,and Pub Med databases,39 articles were finally included according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)The reason for the increased prosthesis dislocation rate of patients with a history of lumbar fusion surgery and undergoing total hip replacement is impingement,and the most economical and effective way to study impact is the sagittal X-ray of the lumbar pelvis.(2)After lumbar fusion,the lumbar spine affects the sagittal plane of pelvis through balance and mobility,increasing impact risk:the lumbar spine is severely unbalanced,causing the pelvis to tilt backward and the acetabulum to be vertical,increasing the risk of impact;stiffness of the lumbar spine leads to decreased pelvic mobility and increased hip joint mobility,which increases the risk of impact.(3)The relationship between the sagittal plane of lumbar spine,pelvis and hip joint has a wide range of applications.
作者
王亚超
黄健
Wang Yachao;Huang Jian(Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第30期4870-4876,共7页
Chinese Journal of Tissue Engineering Research
关键词
腰椎融合
全髋关节置换
骨盆矢状面
撞击
脱位
lumbar fusion
total hip replacement
pelvic sagittal plane
impingement
dislocation
