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Dislocations after total hip arthroplasty

R Y Woo, B F Morrey

    The Journal of Bone and Joint Surgery. American Volume
    |December 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Previous hip surgery and posterior surgical approaches significantly increase total hip arthroplasty dislocation risk. Osteotomy with trochanteric avulsion also elevates dislocation rates, with persistent instability after revision surgery in many cases.

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    Area of Science:

    • Orthopedic Surgery
    • Biostatistics

    Background:

    • Total hip arthroplasty (THA) is a common procedure for hip joint disease.
    • Dislocation remains a significant complication following THA, impacting patient outcomes.

    Purpose of the Study:

    • To identify risk factors for dislocation after conventional total hip arthroplasty.
    • To analyze the impact of surgical approach and prior hip surgery on dislocation rates.

    Main Methods:

    • Retrospective analysis of 10,500 conventional total hip arthroplasties performed between 1968 and 1978.
    • Multivariate analysis to assess correlations between patient/surgical factors and dislocation incidence.
    • Comparison of dislocation rates based on surgical approach, previous hip surgery, and trochanteric osteotomy status.

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    Main Results:

    • Previous hip surgery was the most significant risk factor, doubling dislocation incidence (4.8% vs. 2.4%).
    • Posterior surgical approach had a higher dislocation rate (5.8%) compared to anterolateral (2.3%).
    • Hips with osteotomy and greater trochanter avulsion showed a markedly higher dislocation rate (17.6%) versus united osteotomies (2.8%).

    Conclusions:

    • Previous hip surgery and posterior approaches are key risk factors for THA dislocation.
    • Trochanteric osteotomy management significantly influences dislocation risk.
    • Revision surgery for instability has a high rate of persistent instability.