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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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The unstable total hip replacement.

F D'Angelo1, L Murena, G Zatti

  • 1Department of Orthopedics and Traumatology, University of Insubria, Varese - Italy. fabio.dangelo@uninsubria.it

Indian Journal of Orthopaedics
|September 16, 2009
PubMed
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Preventing total hip arthroplasty dislocation is key. Surgeons should consider patient and surgical risk factors, restoring leg length and offset, and using larger femoral heads for high-risk patients.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Total hip arthroplasty dislocation is a common complication with a persistent 3.2% rate.
  • Despite advancements, the overall dislocation rate in hip replacement has not decreased.

Purpose of the Study:

  • To review recent literature on total hip arthroplasty dislocation.
  • To identify key risk factors and standardize treatment protocols for prosthetic hip dislocation.

Main Methods:

  • Literature search of Medline database (1980-2007).
  • Keywords: "hip dislocation", "hip instability".
  • Inclusion criteria: English publications, clinical trials, and review papers.

Main Results:

  • Dislocation risk is highest in the early months post-surgery but can occur years later.
Keywords:
Dislocationhip arthroplastyrevision

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  • Identified risk factors include surgical approach, head diameter, impingement, component malposition, and abductor muscle insufficiency.
  • Various treatment options exist, including bracing, component reorientation, and surgical interventions.

    • Conclusions:

    • Preventing dislocation is the primary goal.
    • Surgeons must assess patient and surgical risks, optimize leg length and femoral offset, and consider specific techniques for high-risk individuals.
    • Patient education and postoperative care are crucial for managing dislocation risk.