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Dislocation after total hip arthroplasty using the anterolateral abductor split approach
T H Mallory1, A V Lombardi, R A Fada
1Joint Implant Surgeons, Inc, Columbus, OH 43215, USA.
Insights
The anterolateral abductor split approach for total hip arthroplasty shows a low dislocation rate (<1%). This surgical technique is effective in minimizing postoperative dislocation, especially for high-risk patients.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
Background:
- Total hip arthroplasty (THA) utilizes transtrochanteric, posterior, and anterolateral surgical approaches.
- Complications include dislocation, nonunion, heterotopic ossification, neurovascular damage, limp, and malalignment.
Purpose of the Study:
- To evaluate the efficacy of the anterolateral abductor split approach in primary total hip arthroplasty.
- To assess the postoperative dislocation rate associated with this specific surgical technique.
Main Methods:
- Retrospective review of a consecutive series of 1518 primary total hip arthroplasty cases.
- Analysis of dislocation rates stratified by preoperative diagnosis.
Main Results:
- An overall dislocation rate of 0.79% (12 of 1518 cases) was reported.
- Patients with prior trauma or congenital hip dysplasia faced the highest dislocation risk.
Conclusions:
- The anterolateral abductor split approach offers excellent hip joint visualization and neurovascular protection.
- This approach can significantly minimize postoperative dislocation rates in primary THA, even in high-risk patient groups.
Abstract:
The three basic surgical approaches used most commonly in total hip arthroplasty are transtrochanteric, posterior, and anterolateral. Complications related to each of these surgical approaches have been reported including dislocation, trochanteric nonunion, heterotopic ossification, neurovascular damage, postoperative limp, and implant malalignment. The anterolateral abductor split approach previously has been reported to allow ease of access into the hip joint, optimum joint visualization, protection of neurovascular structures of the hip, and predictable results for postoperative hip function restoration. Reviewing a large consecutive series of primary total hip arthroplasty cases (1518), the authors report an overall dislocation rate less than 1% (12:1518; 0.79%). Stratified by preoperative diagnosis, patients undergoing total hip arthroplasty after trauma, or presenting with congenital dysplastic hip are at the highest risk for postoperative dislocation. Primary total hip arthroplasty using the anterolateral, abductor split approach can minimize the rate of postoperative dislocation in the prevailing preoperative diagnostic categories.