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Related Experiment Videos

Late dislocation after total hip arthroplasty.

Marius von Knoch1, Daniel J Berry, W Scott Harmsen

  • 1Mayo Clinic, 200 First Street S.W., Rochester, MN 55902, USA.

The Journal of Bone and Joint Surgery. American Volume
|November 14, 2002
PubMed
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Late dislocation after total hip arthroplasty is more common than previously believed, affecting 0.8% of patients. Risk factors include female sex, younger age at surgery, and various implant-related issues, with a high recurrence rate.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Patient Outcomes Research

Background:

  • Late dislocation is a recognized complication of total hip arthroplasty (THA).
  • Risk factors and outcomes for late THA dislocations remain poorly understood.
  • This study investigates the prevalence, associated factors, and outcomes of late THA dislocations.

Purpose of the Study:

  • Determine the prevalence of late dislocation after primary THA.
  • Characterize demographic and clinical factors associated with late dislocations.
  • Report the outcomes, including recurrence and reoperation rates, of late THA dislocations.

Main Methods:

  • A retrospective review of 19,680 primary THAs performed between 1969 and 1995.
  • Prospective surveillance identified dislocations, with late dislocations defined as occurring ≥5 years postoperatively.

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  • Analysis of patient demographics, clinical factors, radiographic findings, and treatment outcomes.

    • Main Results:

    • Late dislocation occurred in 0.8% of the cohort (165 hips), with a median onset of 11.3 years post-THA.
    • Late dislocation was more common in women and associated with younger age at primary THA.
    • Identified risk factors included prior subluxations, trauma, neurologic impairment, polyethylene wear, implant loosening, and acetabular malposition.
    • Recurrence rate was 55%, with 33% requiring reoperation.

    Conclusions:

    • Late dislocation after THA is more frequent than previously assumed.
    • Distinct etiologies, including prosthesis issues, new complications, or combined factors, contribute to late dislocations.
    • The high recurrence rate necessitates careful consideration of management strategies.