Risk factors for early dislocation after total hip arthroplasty: a matched case-control study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Total hip arthroplasty (THA) is a common procedure to address hip joint degeneration.
• Early dislocation after THA remains a significant complication, impacting patient outcomes and healthcare costs.

Purpose of the Study:

• To identify and evaluate key risk factors associated with early dislocation following primary total hip arthroplasty (THA).

Main Methods:

• A retrospective case-control study involving 175 dislocation cases and 651 controls matched for various demographic and surgical parameters.
• Analysis of acetabular and femoral component positioning (version, inclination) and femoral head size.
• Assessment of surgical approach (posterior vs. anterolateral/lateral) as a potential risk factor.

Main Results:

• The posterior surgical approach demonstrated a significantly higher risk of dislocation (OR=6.3) compared to other approaches.
• Suboptimal combined cup and stem positioning increased dislocation risk (OR=2.59).
• Larger femoral head sizes were associated with a reduced risk of dislocation (OR=0.84).

Conclusions:

• Surgical approach, particularly the posterior approach, is a critical risk factor for early THA dislocation.
• Combined positioning of the acetabular and femoral components significantly influences dislocation risk.
• Femoral head size is an important modifiable factor in mitigating dislocation risk after THA.