Is dislocation rate higher in total hip arthroplasty done for acute displaced fracture neck of femur?

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.

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Faculty Opinions recommendation of Primary total hip arthroplasty versus internal fixation in displaced fracture of femoral neck in sexa- and septuagenarians.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718227355.793521357 ◽

2016 ◽

Author(s):

Mark D Neuman

Keyword(s):

Total Hip Arthroplasty ◽

Femoral Neck ◽

Internal Fixation ◽

Hip Arthroplasty ◽

Total Hip ◽

Displaced Fracture ◽

Primary Total Hip Arthroplasty

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Analysis of total hip arthroplasty for displaced intracapsular neck of femur fractures in a tertiary referral trauma centre

Injury Extra ◽

10.1016/j.injury.2012.07.295 ◽

2012 ◽

Vol 43 (10) ◽

pp. 105

Author(s):

Z. Gamie ◽

J. Neale ◽

D. Shields ◽

J. Claydon ◽

S. Hazarika ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Trauma Centre ◽

Tertiary Referral ◽

Neck Of Femur ◽

Total Hip ◽

Femur Fractures

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Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results

The Open Orthopaedics Journal ◽

10.2174/1874325001509010157 ◽

2015 ◽

Vol 9 (1) ◽

pp. 157-162 ◽

Cited By ~ 38

Author(s):

Sachiyuki Tsukada ◽

Motohiro Wakui

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Anterior Approach ◽

Posterior Approach ◽

Direct Anterior Approach ◽

Dislocation Rate ◽

Rank Test ◽

Consecutive Series ◽

Total Hip

Objective: The aim of the study was to compare the dislocation rate between total hip arthroplasty (THA) via direct anterior approach (DAA) and via posterior approach (PA). Methods: We compared a consecutive series of 139 THAs via DAA with 177 THAs via PA. All study patients received ceramic-on-ceramic bearing surfaces and similar uncemented prostheses. Dislocation-free survival after THA was estimated using the Kaplan–Meier survival method and compared between groups using the log-rank test. Results: In the DAA group, none of 139 hips experienced dislocations in five-year-average follow-up. In the PA group, seven hips experienced dislocations among 177 hips (4 %). The dislocation was significantly less in the DAA group compared to the PA group (p = 0.033). Conclusion: The dislocation rate of THA via DAA was significantly less than that of THA via PA.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210622 ◽

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

Background: Study aimed to assess and compare the functional outcome in patients underwent the large femoral head THA and conventional femoral head THA.Methods: 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.Results: 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<0.001)Conclusions: 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.

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