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

目的探讨后路老年初次全髋关节置换术中关节囊修补及其对术后早期脱位的影响。方法分析1996年11月至2007年5月行K—L入路治疗老年初次全髋关节置换的股骨颈骨折患者120例，均为单髋病例。根据术中是否进行关节囊的修补及外旋肌群的修复分为两组：A组术中切除后关节囊，行外旋肌群的修补；B组术中“T”形切开关节囊进行修补，并将关节囊与外旋肌群共同缝合于大转子及臀中肌止点。结果A组80例，16例失随访，术后早期脱位2例2髋（2．5％）。B组40例，1例失随访，无一例出现术后早期脱位。结论后路关节囊及软组织袖修补方法简单，不增加手术创伤，可以有效发挥阻挡作用，降低术后早期脱位率。

Effect of posterior capsular repair on early dislocation in elderly patients with primary total hip arthroplasty

Objectives To explore the effect and procedure of posterior approach to total hip arthroplasty （THA） with capsular repair in the elderly. Methods From November 1996 to May 2007, 120 patients with fracture of femoral neck were treated using posterior K - L approach to total hip replacement. All of them were divided into 2 groups. Group A （ n = 80 hips） were treated by removing articular capsules and repairing short external rotator muscles. Group B （ n = 40 hips） were treated by repairing the posterior articular capsules with ＂T＂ shape incision and suturing articular capsules and short external rotators muscles on greater trochanter and gluteus medius. Results In group A, 16 patietns were lost and 2 posterior dislocations were found （2. 5% ）. While, no dislocation was found in group B and one was lost. Conclusion It is a simple work and minimal trauma for repair of capsular and short external rotators muscles to reconstruct the posterior sleeve after THA. Also, it can decrease the ineidence of dislocation after posterior approach to THA.