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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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Prevention of Dislocation After Total Hip Arthroplasty
Fiachra E Rowan1, Biju Benjamin1, Jurek R Pietrak1
1Department of Trauma and Orthopaedic Surgery, University College London Hospital, London, United Kingdom.
The Journal of Arthroplasty
|March 12, 2018
Summary
Preventing dislocation after total hip arthroplasty (THA) involves assessing patient risk factors like age and BMI. Advanced techniques and implants may reduce dislocation rates, moving towards personalized THA surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Preventing dislocation is crucial after primary total hip arthroplasty (THA).
- Preoperative patient assessment and planning are the first steps in dislocation prevention.
Purpose of the Study:
- To assess historical and current strategies for preventing dislocation after primary THA.
- To identify factors influencing THA dislocation rates.
Main Methods:
- A comprehensive literature search was conducted.
- 3458 articles were reviewed, with 154 included in the analysis.
Main Results:
- Factors influencing dislocation include extremes of age, high BMI, lumbosacral pathology, surgeon experience, and femoral head size.
- Evidence is mixed for neuromuscular disease, pediatric hip conditions, and surgical approach.
- Sex, simultaneous bilateral THA, and postoperative restrictions do not impact dislocation rates.
- Navigation, robotics, lipped liners, and dual-mobility components may reduce dislocation.
Conclusions:
- Identify and mitigate risks for THA dislocation.
- Acetabular component positioning 'safe zones' are outdated.
- Current THA surgery is increasingly personalized.
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