Outcome of revision surgery in recurrent dislocation of primary total hip arthroplasty

2020 ◽  
pp. 112070002091114
Author(s):  
Nisarg Mehta ◽  
Veenesh Selvaratnam ◽  
Joseph Alsousou ◽  
Nigel Donnachie ◽  
Fintan Adrian Carroll
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Recurrent Dislocation ◽  
Median Number ◽  
Dislocation Rate ◽  
Neck Of Femur ◽  
Total Hip ◽  
Late Dislocation ◽  
Primary Total Hip Arthroplasty

Background: The cause of recurrent dislocation following primary total hip arthroplasty (THA) is multifactorial. A re-dislocation rate of up-to 34% following revision is reported. The aim of this study was to determine the re-dislocation rates following revision for recurrent THR dislocation. Methodology: Patients who underwent revision for recurrent dislocation between January 2008 and January 2015 were identified. We identified the date and type of primary implant, overall number and reasons for dislocation, revision implant details and complication data. Results: Over an 8-year period, 24 patients underwent revision. The median age was 77 (68–85) years, median time to first dislocation was 78 (23–160) months and median number of dislocations was 3 (2–4) with a mean follow-up of 18 months. Socket Mal-Orientation (10) and Abductor deficiency (5) were the main causes of recurrent dislocation. 21 patients (88%) underwent revision of both components, 1 patient underwent isolated cup revision and 2 patients had revision of acetabular component with insertion of a BioBall. There were no dislocations within 90 days of revision surgery. 4 patients had late dislocations (3 recurrent, 1 isolated). There was no significant increase risk of dislocation after revision surgery in the neck of femur group ( p  = 0.467). Conclusions: We report favourable outcomes for revision of both components for recurrent dislocation with no dislocations within 90 days. The overall late dislocation rate was 16.7%, however, these patients have settled following closed reduction. Due to its multifactorial aetiology, both component revision can be considered in this patient population.

scholarly journals Is large femoral head a better option than a conventional femoral head primary total hip arthroplasty in Indian population

2021 ◽  
Vol 7 (2) ◽  
pp. 295
Author(s):  
Hiranya Kumar Seenappa ◽  
Karthik Mittemari Naraynamurthy ◽  
Rasiq Rashid ◽  
Shivraj Nadagouda ◽  
Vamshhikrishna Chand
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Age Group ◽  
Neck Of Femur ◽  
Large Femoral Head ◽  
Total Hip ◽  
Modified Harris Hip Score ◽  
Primary Total Hip Arthroplasty

<p class="abstract"><strong>Background: </strong>Study aimed to assess and compare the functional outcome in patients underwent the large femoral head THA and conventional femoral head THA.</p><p class="abstract"><strong>Methods:</strong> It is a comparative prospective cross sectional study conducted among the patients undergoing primary total hip arthroplasty through postero-lateral approach at department of orthopaedics Vydehi institute of medical sciences, Bengaluru during the period of July 2017 to July 2019. Patients aged between 18-80years of both genders undergoing Primary THA for Osteoarthritis (OA), Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Post traumatic arthritis, Avascular necrosis (AVN), Acute fracture neck of femur, Non-union fracture neck of femur (NOF). Patients undergoing primary total hip arthroplasty in Intertrochanteric fracture, Acetabular fracture and patients undergoing Revision Hip Arthroplasty were excluded from study. Patients were grouped as the ones treated with large femoral head THA and conventional femoral head THA.</p><p class="abstract"><strong>Results: </strong>This series consisted of 36 patients with 44 diseased hips treated with primary total hip arthroplasty (THA). Out of 36 patients, 9 patients (25%) belonged to an age group of below 30 years of age, 10 patients (27.8%) belonged to the age group between 31-40 years of age, 8 patients (22.2%) belonged to the age group 41-51 years of age and 9 patients (25%) belonged to age group of 51-60 years of age. The mean level of Modified Harris Hip score and improvement of movements in all planes was found to be statistically significantly in the patients treated with large femoral head primary THA compared to those treated with conventional method. (p&lt;0.001)</p><p class="abstract"><strong>Conclusions: </strong>Study has shown improved functional outcome (Modified harris hip score) and range of movement in the patients treated with the large femoral head primary THA as compared to those treated with a conventional femoral head.</p>

Reduction in Early Dislocation Rate With Large-Diameter Femoral Heads in Primary Total Hip Arthroplasty

2007 ◽  
Vol 22 (6) ◽  
pp. 140-144 ◽  
Author(s):  
Christopher L. Peters ◽  
Edward McPherson ◽  
Jeffrey D. Jackson ◽  
Jill A. Erickson
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Dislocation Rate ◽  
Total Hip ◽  
Femoral Heads ◽  
Primary Total Hip Arthroplasty

scholarly journals Patient and implant survival following intraoperative periprosthetic femoral fractures during primary total hip arthroplasty

2019 ◽  
Vol 101-B (10) ◽  
pp. 1199-1208 ◽  
Author(s):  
Jonathan N. Lamb ◽  
Gulraj S. Matharu ◽  
Anthony Redmond ◽  
Andrew Judge ◽  
Robert M. West ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Cox Regression ◽  
Patient Survival ◽  
Femoral Fractures ◽  
Trochanteric Fracture ◽  
Total Hip ◽  
Periprosthetic Femoral Fractures ◽  
Primary Total Hip Arthroplasty

Aims We compared implant and patient survival following intraoperative periprosthetic femoral fractures (IOPFFs) during primary total hip arthroplasty (THA) with matched controls. Patients and Methods This retrospective cohort study compared 4831 hips with IOPFF and 48 154 propensity score matched primary THAs without IOPFF implanted between 2004 and 2016, which had been recorded on a national joint registry. Implant and patient survival rates were compared between groups using Cox regression. Results Ten-year stem survival was worse in the IOPFF group (p < 0.001). Risk of revision for aseptic loosening increased 7.2-fold following shaft fracture and almost 2.8-fold after trochanteric fracture (p < 0.001). Risk of periprosthetic fracture of the femur revision increased 4.3-fold following calcar-crack and 3.6-fold after trochanteric fracture (p < 0.01). Risk of instability revision was 3.6-fold after trochanteric fracture and 2.4-fold after calcar crack (p < 0.001). Risk of 90-day mortality following IOPFF without revision was 1.7-fold and 4.0-fold after IOPFF with early revision surgery versus uncomplicated THA (p < 0.001). Conclusion IOPFF increases risk of stem revision and mortality up to ten years following surgery. The risk of revision depends on IOPFF subtype and mortality risk increases with subsequent revision surgery. Surgeons should carefully diagnose and treat IOPFF to minimize fracture progression and implant failure. Cite this article: Bone Joint J 2019;101-B:1199–1208

The effect of precautions on early dislocations post total hip arthroplasty: a retrospective cohort study

2018 ◽  
Vol 28 (5) ◽  
pp. 485-490 ◽  
Author(s):  
Felix C Allen ◽  
Daniel L Skinner ◽  
Jane Harrison ◽  
Giles H Stafford
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Recent Literature ◽  
Dislocation Rate ◽  
Electronic Database ◽  
Total Hip ◽  
Oxford Hip Score ◽  
Hip Precautions ◽  
Primary Total Hip Arthroplasty

Introduction: The efficacy of hip precautions in preventing dislocation post total hip arthroplasty (THA) has been questioned in recent literature. From 2014 our centre ceased routinely prescribing them due to lack of evidence. We investigate the effect of stopping these precautions on dislocation rate, patient satisfaction and Oxford hip score (OHS). Methods: Patients who underwent primary total hip arthroplasty prior to this change in protocol ( n = 2551) and for 1 year subsequently ( n = 673) were identified. Operative records were used to identify key demographic and operative data. Incidence of dislocation, OHS and patient satisfaction were extracted from the centre’s electronic database. Subset analysis of those patients dislocating within 6 weeks was performed. Results: Rate of dislocation at 6 weeks in those prescribed and not prescribed precautions was 0.71% and 0.89% respectively ( p = 0.618). At 1 year this rose to 1.25% and 1.49% ( p = 0.406). Satisfaction ( p = 0.332) and OHS ( p = 0.441) at 1 year was not significantly different between cohorts. Conclusions: Cessation of prescribing routine hip precautions post primary THA does not appear to significantly affect overall dislocation rate, patient satisfaction or functional status at 1 year post-operatively.

Early Dislocation Rate with Large Femoral Heads in Primary Total Hip Arthroplasty

2007 ◽  
Vol 19 (4) ◽  
pp. 468 ◽  
Author(s):  
Yong Ju Kim ◽  
Hoon Jeong ◽  
Kwan Hee Lee ◽  
Jong Kyoung Ha ◽  
Jung Suk Oh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Dislocation Rate ◽  
Total Hip ◽  
Femoral Heads ◽  
Large Femoral Heads ◽  
Primary Total Hip Arthroplasty
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