Trochanteric advancement for recurrent dislocation after total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Recurrent dislocations after total hip arthroplasty (THA) significantly impact patient quality of life.
• Identifying the underlying causes of dislocation, such as component malposition or impingement, is crucial before surgical intervention.

Purpose of the Study:

• To evaluate the efficacy and safety of trochanteric advancement in preventing recurrent dislocations post-THA.
• To assess the outcomes of trochanteric advancement in patients with previously unexplained dislocations.

Main Methods:

• A cohort of 21 patients with recurrent dislocations after THA underwent trochanteric advancement.
• Pre-operative assessment excluded component malposition and mechanical impingement.
• Radiographic measurements documented the degree of trochanteric advancement.

Main Results:

• Seventeen of 21 hips (81%) experienced no further dislocations after trochanteric advancement, with a mean follow-up of 2.7 years.
• Four patients with rheumatoid arthritis had significant trochanteric migration (>1 cm), with two experiencing subsequent dislocations.
• Only one patient with a technically sound procedure had persistent dislocations.

Conclusions:

• Trochanteric advancement is a safe and effective surgical option for preventing recurrent dislocations in total hip arthroplasty patients.
• The procedure is particularly beneficial when component malposition or impingement have been excluded as causes of instability.