Original article
Prognosis of dislocation after total hip arthroplasty

https://doi.org/10.1016/S0883-5403(98)90070-5Get rights and content

Abstract

One hundred sixty-one dislocations after cemented total hip arthroplasty, with a mean follow-up period of 8 years after dislocation, were reviewed with the aim of establishing the prognosis. There were 84% single and 16% recurrent dislocations. Closed reduction was successful in 81% of cases. Thirty-seven percent of dislocations were early (within 5 weeks), 36% occurred in patients who had had previous surgery, and in 47% there was nonunion of the trochanter. There was a two-way interaction between these factors, and all factors were significant for recurrent dislocation. Twenty-six (16%) recurrent dislocations required surgery. The most common causes of recurrent dislocation demonstrated at operation were component malposition (58%) and failure of the abductor mechanism (42%). In total, 96% of cases were successfully treated.

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Cited by (86)

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    2021, Arthroplasty Today
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    Dislocation after primary total hip arthroplasty (THA) has a reported incidence ranging from 0.6% to 4% [1]. Of those, 16% to 36% may sustain recurrent THA dislocation [2-4]. Multiple factors contributing to recurrent instability, including component orientation, femoral head size, impingement, polyethylene wear, patient age, patient gender, and choice of surgical approach, have been described [5-7].

  • Investigation of the Unstable Total Hip Arthroplasty

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    If the dislocation is an isolated event in the early postoperative period, within 3 months of surgery, with implants that are well positioned, the patient can expect a reasonable chance of closed reduction rendering the hip stable without further surgical intervention. Studies show a success rate of 67-81% for closed reduction of an early dislocation after a THA [1,2]. Conversely, if more than once dislocation has occurred remote from the original surgery, the chance of closed reduction rendering the hip stable without further surgery is less likely.

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