Posterior Capsule Reconstruction with Polypropylene Mesh After Total Hip Arthroplasty

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science

Background:

• Total hip arthroplasty (THA) instability is a significant clinical challenge.
• Posterior capsular deficiency contributes to THA instability.
• Previous attempts at posterior capsule reconstruction have yielded variable results.

Purpose of the Study:

• To evaluate the mid-term survivorship and clinical outcomes of posterior capsule reconstruction using a monofilament polypropylene mesh in patients with unstable THA.
• To identify factors influencing the success of mesh reconstruction for THA instability.

Main Methods:

• A retrospective review of 24 hips that underwent posterior capsule reconstruction with polypropylene mesh for THA instability.
• Analysis of survivorship, re-operation rates, and dislocation events.
• Comparison of outcomes between hips with and without a history of prior revision surgery.

Main Results:

• Overall survivorship was 70.8% at a mean follow-up of 6.5 years.
• Six patients (25%) required re-operation, and one mesh removal occurred.
• Hips with a history of prior revision (n=8) had a significantly higher re-dislocation rate (62.5%) compared to hips without prior revision (12.5%, p = 0.02).

Conclusions:

• Posterior capsule reconstruction with polypropylene mesh demonstrates reasonable mid-term survivorship for managing THA instability.
• A history of prior revision surgery is a significant risk factor for re-dislocation after mesh reconstruction.
• This technique may be a viable option for select unstable THA cases, particularly those without prior revision history.