摘要
目的探讨术中臀大肌止点部分切断与老年患者初次行后外侧入路的全髋关节置换术(THA)后假体脱位的相关性。方法回顾性分析2012年6月至2021年12月于浙江大学医学院附属第二医院骨科行初次行后外侧入路THA的患者资料。依据术后是否发生髋关节脱位将其分为脱位组(44例)与正常组(132例),并记录包括性别、年龄、身高、体重、体质量指数(BMI)及术中是否有臀大肌止点部分切断等。统计患者手术假体放置情况,包括髋臼前倾角、髋臼外展角、股骨侧偏心距、髋臼侧偏心距。结果正常组中臀大肌部分切断的患者有17例;保留组有115例。脱位组中部分切断组有13例;保留组有31例。脱位组中臀大肌部分切开的患者所占比例多于正常组(P=0.011)。脱位组的女性患者占比多于正常组,差异有统计学意义(P=0.006)。比较股骨侧偏心距时脱位组较正常组小[(33.8±9.5)mm比(38.3±7.0)mm,P=0.005]。比较髋臼侧偏心距时脱位组较正常组小[(70.2±9.7)mm比(73.8±7.5)mm,P=0.029]。脱位组中假体位于安全区内有33例;安全区外有11例;正常组安全区内有95例;安全区外有37例;差异无统计学意义(P=0.627)。结论术中臀大肌部分切断、女性、偏小的髋臼侧偏心距以及偏小的股骨侧偏心距与THA术后脱位有着密切关系。
Objective To investigate the correlation between intraoperative partial sever of gluteus maximus muscle and prosthesis dislocation in elderly patients after initial total hip replacement with posterolateral approach.Methods The patients underwent the initial posterolateral approach THA in Department of Orthopedics,the Second Affiliated Hospital Zhejiang University School of Medicine from June 2012 to December 2021.According to whether hip dislocation occurred after operation,the patients were divided into dislocation group(44)and normal group(132).The recorded data included gender,age,height,weight,BMI and there was partial amputation of gluteus maximus muscle.The placement of the patient's surgical prosthesis was recorded,including acetabular anteversion angle,acetabular abduction D0I:10.19548/i 2096-269x.2024.04.005 angle,femoral offset and acetabular offset.Results In the normal group,there were 17 patients with partial sever of gluteus maximus muscle and 115 patients with preservation of gluteus maximus,In the dislocation group,there were 13 patients with partial sever of gluteus maximus muscle and 31 patients with preservation of gluteus maximus.The proportion of patients with partial sever of gluteus maximus muscle was higher in the dislocation group than in the normal group(P=0.011).The proportion of female patients in the dislocation group was higher than that in the normal group(P=0.006).The femoral offset was smaller in the dislocation group than in the normal group[(33.8±9.5)mm vs.(38.3±7.0)mm,P=0.005].The acetabular offset was smaller in the dislocation group than in the normal group[(70.2±9.7)mm vs.(73.8±7.5)mm,P=0.029].In the dislocation group,the prosthesis was located in the safe zone in 33 patients and outside the safe zone in 11 patients.In the normal group,the prosthesis was located in the safe zone in 95 patients and outside the safe zone in 37 patients(P=0.627).Conclusion The partially severed gluteus maximus muscle during the operation,female,small femoral offset and small acetabular off
作者
吴志立
毛锦洋
祝俊雄
郑力铭
蒋利锋
Wu Zhili;Mao Jinyang;Zhu Junxiong;Zheng Liming;Jiang Lifeng(Department of Orthopedics,the Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310052,China)
出处
《骨科临床与研究杂志》
2024年第4期217-223,共7页
Journal Of Clinical Orthopedics And Research
关键词
关节成形术
置换
髋
关节脱位
危险因素
臀大肌
Arthroplasty,replacement,hip
Joint dislocation
Risk factors
Gluteus
