Hip Joint Instability After Surgery Performed Through the Surgical Dislocation Approach.

Area of Science:

• Orthopedic Surgery
• Hip Preservation Surgery

Background:

• Safe surgical hip dislocation is a valuable technique with a low complication rate.
• Hip joint instability is a severe complication with a poor prognosis.

Purpose of the Study:

• To investigate the incidence and risk factors of hip joint instability following safe surgical dislocation.
• To evaluate outcomes of instability treatment after hip preservation surgery.

Main Methods:

• Prospective study of 459 hips treated with safe surgical dislocation from 2000-2021.
• Instability diagnosed intraoperatively and postoperatively; risk factors and outcomes were recorded.
• Patient demographics, initial deformities, and radiographic findings were analyzed.

Main Results:

• Hip joint instability occurred in 22/459 hips (4.8%).
• Contributing factors included acetabular deficiency, coxa breva/valga, posterior impingement, increased anteversion, soft tissue laxity, obesity, and inadequate postoperative precautions.
• 50% of unstable hips resolved; chondrolysis and subluxation were common in others.

Conclusions:

• Safe surgical dislocation impacts soft tissue restraints, making stability dependent on bone morphology, abductor function, and precautions.
• Identifying and mitigating risk factors like bony deformities and ensuring adherence to postoperative protocols can reduce instability incidence.
• Further research into subjective risk factors and optimized treatment strategies is warranted.