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Dislocations after total hip-replacement arthroplasties.

G E Lewinnek, J L Lewis, R Tarr

    The Journal of Bone and Joint Surgery. American Volume
    |March 1, 1978
    PubMed
    Summary
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    Total hip replacement dislocations are linked to acetabular cup orientation. Specific anteversion and lateral opening angles reduce dislocation risk, especially within the first 30 days post-surgery.

    Area of Science:

    • Orthopedic Surgery
    • Biomedical Engineering

    Background:

    • Total hip replacement (THR) is a common procedure to alleviate hip pain.
    • Dislocation remains a significant complication following THR.
    • Acetabular cup positioning is crucial for implant stability and function.

    Purpose of the Study:

    • To investigate the relationship between acetabular cup orientation and dislocation after total hip replacement.
    • To identify specific orientation parameters associated with increased dislocation risk.
    • To define a "safe" range for acetabular cup orientation to minimize dislocations.

    Main Methods:

    • Analysis of 300 total hip replacement cases.
    • Precise measurement of acetabular component anteversion and lateral opening angles.
    • Correlation of cup orientation with dislocation events (anterior and posterior).

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  • Evaluation of risk factors including time post-surgery and surgical history.

    • Main Results:

    • Nine dislocations (3%) occurred in 300 THR procedures.
    • Anterior dislocations were significantly associated with increased acetabular-component anteversion.
    • No significant correlation was found between cup orientation angle and posterior dislocation.
    • Dislocation rate was 1.5% within the "safe" range (15 +/- 10 degrees anteversion, 40 +/- 10 degrees lateral opening) versus 6.1% outside this range.
    • Higher dislocation risk observed within 30 days post-surgery and in patients with prior hip surgery.

    Conclusions:

    • Acetabular component anteversion is a critical factor in anterior hip dislocations after THR.
    • A specific range of acetabular cup orientation (15 +/- 10 degrees anteversion, 40 +/- 10 degrees lateral opening) is associated with a lower dislocation rate.
    • Optimizing acetabular cup positioning is essential for improving total hip replacement outcomes and reducing complication rates.