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Dislocation after total hip arthroplasty: risk factors and treatment options
Ulf Gunther Leichtle1, Carmen Ina Leichtle, Ferdane Taslaci
1Department of Orthopedics, University Hospital Tübingen, Tübingen, Germany.
Objective:
The aim of this study was to analyze the setting for dislocations and redislocations after primary and revision total hip arthroplasty (THA), identify risk factors and optimize treatment.
Methods:
This study included 56 patients with a dislocated hip following THA (n=5,205) between 1984 and 2005 and a matched control group (n=55). Hospital charts and radiographs of all patients in both groups were analyzed. Thirty-one patients in the study group were followed both clinically and radiologically.
Results:
The dislocation rate after primary THA was 1.1% (56/5,205) and the redislocation rate after a first occurrence was as high as 39%. There was a positive correlation between the time intervals from the surgery to first dislocation and from the first dislocation to second dislocation (r=0.4). Most of the primary dislocations occurred within a short period of time after surgery, thus favoring consecutive dislocations. Female gender, as well as revision arthroplasty, was associated with a higher incidence of dislocations. No relation was found between the orientation of the acetabular cup and dislocation.
Conclusion:
To prevent redislocations after the first occurrence, we suggest thorough evaluation of possible technical faults which should be addressed surgically. Considering the high redislocation rate, we also advocate a stringent conservative treatment regime especially after the first THA dislocation.
