Abstract
Objective To analyze the incidence of prosthesis dislocation,risk factors,and prevention strategies following total hip replacement in elderly patients.Methods A total of 1,523 elderly patients who underwent total hip replacement at Qixian Traditional Chinese Medicine Hospital from January 2012 to December 2022 were included(1,610 patients collected,87 lost to follow-up).All patients were followed for 6 months.Among them,38 patients who experienced prosthesis dislocation during the follow-up period(49 collected,11 lost to follow-up)were assigned to the dislocation group,while 1,485 patients without dislocation during the follow-up(1,561 collected,76 lost to follow-up)formed the control group.A retrospective study was conducted.The age,sex,hypertension,diabetes,hip surgery history,hormone use,surgical approach,diameter of the artificial femoral head,postoperative femoral prosthesis anteversion angle,prosthesis placement position,surgical time,blood loss during surgery,length of hospital stay,transfer situation postoperatively,and position control were recorded and compared between the two groups.Multiple logistic regression analysis was employed to identify independent risk factors for prosthesis dislocation following total hip replacement in the elderly.Results Among the 1,523 patients,38 experienced prosthesis dislocation within 6 months post-surgery,resulting in a dislocation rate of 2.50%.There were statistically significant differences in age,diabetes,hip surgery history,surgical approach,diameter of the artificial femoral head,postoperative femoral prosthesis anteversion angle,prosthesis placement position,postoperative transfer,and position control between the two groups(P＜0.05).However,no statistically significant differences were found in sex,hypertension,hormone use,surgical time,blood loss during surgery,or length of hospital stay(P＞0.05).Through multiple logistic regression analysis,age,history of hip surgery,use of the posterolateral approach,diameter of the artificial femoral head＜30 mm,postoperative femoral prosthesis anteversion angle≥10°,placement of the prosthesis outside the safe zone,improper transfer postoperatively,and inadequate position control were identified as independent risk factors for prosthesis dislocation following total hip replacement in the elderly,with statistical significance(P＜0.05).Conclusion Elderly patients undergoing total hip replacement with factors such as advanced age,history of hip surgery,use of the posterolateral approach,diameter of the artificial femoral head＜30 mm,postoperative femoral prosthesis anteversion angle≥10°,placement of the prosthesis outside the safe zone,improper postoperative transfer,and inadequate position control are at higher risk for postoperative dislocation.Clinical nursing interventions should be strengthened,and targeted measures should be actively implemented based on the identified risk factors to reduce the incidence of postoperative dislocation.关键词
全髋关节置换术/术后假体脱位/影响因素/防范策略Key words
Total hip replacement/postoperative prosthesis dislocation/risk factors/prevention strategies分类
医药卫生
