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Risk Factors for Dislocation After Direct Anterior Total Hip Arthroplasty.

Lincoln Pratson1, Devon R Pekas2, Mehmet Kilinc2

  • 1Wake Orthopedics, Raleigh, North Carolina.

The Journal of Arthroplasty
|June 5, 2025
PubMed
Summary
This summary is machine-generated.

Spinal fusion may increase the risk of dislocation after direct anterior approach total hip arthroplasty (THA). Other patient, implant, and radiographic factors were not significantly associated with dislocation in this study.

Keywords:
cup position in hip arthroplastydirect anterior approachdislocation after hip replacementlumbar spinal fusionrisk of hip instabilitytotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Biomechanical Research

Background:

  • Dislocation is a primary reason for revision total hip arthroplasty (THA).
  • Previous studies linked instability after THA to patient factors, implant choices, and abnormal spinopelvic motion, primarily in posterior approach cohorts.
  • This study focuses on risk factors for dislocation specifically within a direct anterior approach (DAA) THA cohort.

Purpose of the Study:

  • To identify demographic, radiographic, and implant-related factors associated with postoperative dislocation in patients undergoing primary THA via the DAA.
  • To analyze risk factors for dislocation in an exclusively DAA THA patient population.

Main Methods:

  • Retrospective review of patients who underwent primary THA via DAA for osteoarthritis between January 2012 and December 2022.
  • Comparison of 27 patients with postoperative dislocation (THA+D) to a matched control group without dislocation.
  • Data collected included demographics, surgical variables, and radiographic parameters; matching was based on age, sex, BMI, and Charlson Comorbidity Index.

Main Results:

  • Patients experiencing dislocation had a significantly higher prevalence of radiographically confirmed lumbar fusion (OR 10.5, P = 0.0016).
  • No significant differences were found in other patient factors (lumbar degenerative disease, narcotic use), implant characteristics (head size, acetabular diameter, neck length), or radiographic parameters (leg-length/offset change, acetabular inclination/anteversion).

Conclusions:

  • Spinal fusion may be an independent risk factor for dislocation following DAA THA.
  • The study could not establish associations between radiographic or implant factors and dislocation due to a limited sample size, warranting further investigation.