俯卧位闭合复位法治疗髋关节置换术后假体脱位OA

ABATRACT Objective To summarize the clinical experience of using the prone closed reduction method for treating pros-thesis dislocation after hip arthroplasty and to explore the factors contributing to early dislocation and the corresponding man-agement strategies.Methods A retrospective analysis was conducted on the clinical data of 6 patients(4 males,2 females;4 left hips,2 right hips;age range 67 to 86 years)with prosthesis dislocation after hip arthroplasty treated with the prone closed reduction method from January 2020 to June 2023.The time of dislocation,type of dislocation,surgical approach,prosthesis position,hip abductor muscle strength,and complications such as nerve injury,periprosthetic fracture,and prosthesis loosening after reduction were observed.The Harris Hip Score at the final follow-up was also evaluated.Results All 6 patients with pros-thesis dislocation after hip arthroplasty successfully underwent closed reduction in the prone position without anesthesia.All 6 patients were followed up for 13 to 48 months.Five cases dislocated within 3 months postoperatively,and one case dislocated at 5 months postoperatively.All cases involved a posterolateral surgical approach and resulted in posterior dislocation.Two cases were dislocations after hemiarthroplasty,and four were after total hip arthroplasty.Five cases were classified as Dorr dislocation type Ⅰ(positional),and one case was type Ⅱ(soft tissue imbalance).The prosthesis position was normal in all 6 patients.Hip abductor muscle strength was normal in 4 patients and decreased in 2 patients.Reduction was successful in all cases,with no complications such as sciatic nerve injury,periprosthetic fracture,or prosthesis loosening.The Harris hip score at the final fol-low-up ranged from 79 to 90 points.Conclusion The prone closed reduction method for treating prosthesis dislocation after hip arthroplasty is simple to perform,has a high success rate,and yields favorable clinical outcomes.