Risk factors for total hip arthroplasty dislocations

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Abstract

Purpose: to identify risk factors of dislocation after total hip arthroplasties and to suggest a model to determine the probability of occurrence of this complication in every patient. Material and methods: since 2000 till 2010 2569 primary and 319 total hip revisions were performed in 2409 patients. The age of patients varied from 15 to 92, average - 58,5. Women were 1582 (65,68%). All procedures were made through the posterior approach (Kocher-Langenbeck). Results: there were 136 dislocations. The authors analyzed three groups of risk factors: 1) related with patient; 2) depending on surgeon; 3) associated with implant design. Most important risk factors were found by the method of logistic regression: age, gender, diagnose, surgeon, cup-to-head ratio. The authors suggested the predictive model of probable dislocation.

About the authors

M. A. Molodov

Yaroslavl Regional Hospital for War Veterans - International Centre for the elderly “Healthy Longevity”

Author for correspondence.
Email: mihamolodov@rambler.ru
Russian Federation

V. V. Danilyak

Yaroslavl Regional Hospital for War Veterans - International Centre for the elderly “Healthy Longevity”

Email: v-danilyak@mail.ru
Russian Federation

V. V. Kluchevsky

Yaroslavl State Medical Academy

Email: noemail@neicon.ru
Russian Federation

S. I. Gilfanov

Yaroslavl State Medical Academy

Email: gilfanov63@rambler.ru
Russian Federation

V. V. Kluchevsky

Yaroslavl Regional Hospital for War Veterans - International Centre for the elderly “Healthy Longevity”; Yaroslavl State Medical Academy

Email: noemail@neicon.ru
Russian Federation

A. A. Vergay

Yaroslavl State Medical Academy

Email: sashavergay@mail.ru
Russian Federation

References

  1. Захарян Н.Г. Вывихи после тотального эндопротезирования тазобедренного сустава [автореф. дис. ... канд. мед. наук]. М.: ГОУ ВПО «РУДН», 2008. 17 с.
  2. Ключевский В.В., Гильфанов С.И., Даниляк В.В., Белов М.В., Худайбергенов М.А., Молодов М.А. Лечение переломов шейки бедра. В кн.: Материалы I съезда травматологов-ортопедов Казахстана: современные технологии диагностики, лечения и реабилитации в травматологии и ортопедии. Астана; 2009. С. 85.
  3. Berry D.J., von Knoch M., Schleck C.D., Harmsen W.S. The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. J. Bone Joint Surg. (Am). 2004; 86:9-14.
  4. Bourne R.B. Etiology of total hip arthroplasty dislocation. In: Proceedings of annual meeting of AAOS. 2007:43.
  5. Cabanela M.E. Epidemiology of instability after total hip arthroplasty. In: Proceedings of annual meeting of AAOS. 2007:42.
  6. Clark C.R., Huddleston H.D., Schoch E.P., Thomas B.J. Leg-length discrepancy after total hip arthroplasty. J. Am. Acad. Orthop. Surg. 2006; 14(1):38-45.
  7. Clarke M.T., Lee P.T.H., Villar R.N. Dislocation after total hip replacement in relation to metal-on-metal bearing surfaces. J. Bone Joint Surg. 2003;85(B):650-654.
  8. Colwell C.W. Jr. Instability after total hip arthroplasty. Current Orthopaedic Practice. 2009; 20(1):8-14.
  9. D'Antonio J.A., Capello W.N., Manley M.T., Naughton M., Sutton K. A titanium-encased alumina ceramic bearing for total hip arthroplasty: 3- to 5-year results. Clin. Orthop. Relat. Res. 2005;441:151-158.
  10. Ekelund A., Rydell N., Nilsson O.S. Total hip arthroplasty in patients 80 years of age and older. Clin. Orthop. 1992; (281):101.
  11. Enocson A., Hedbeck C.J., Tidermark J., Pettersson H., Ponzer S., Lapidus L.J. Dislocation of total hip replacement in patients with fractures of the femoral neck. Acta Orthop. 2009; 80(2):184-189.
  12. Holubowycz O., Howie D., Middleton R.G. Large articulations reduce early dislocation after hip replacement: a randomized controlled trial. In: Proceedings of Annual Meeting of AAOS; 2009:462.
  13. Kwon M.S., Kuskowski M., Mulhall K.J., Macaulay W., Brown T.E., Saleh K.J. Does surgical approach affect total hip arthroplasty dislocation rates? Clin. Orthop. 2006; (447):34-38.
  14. Lee B.P., Berry D.J., Harmsen W.S. Total hip arthroplasty for the treatment of an acute fracture of the femoral neck: long-term results. J. Bone Joint Surg. (Am). 1998; 80:70-75.
  15. Mai K., Hardwick M.E., Walker R.H., Copp S.N., Ezzet K.A., Colwell C.A. Early dislocation rate in ceramic-on-ceramic total hip arthroplasty. HSS J. 2008; 4(1):10-13.
  16. Masonis J.L., Bourne R.B. Surgical approach, abductor function and total hip arthroplasty dislocation. Clin. Orthop. 2002; (405):46-53.
  17. Meek R.M., Allan D.B., McPhillips G., Kerr L., Howie C.R. Late dislocation after total hip arthroplasty. Clin. Med. Res. 2008; 6(1):17-23.
  18. Morrey B.F. Instability after total hip arthroplasty. Orthopedic Clinics of North America. 1992; 23:237-248.
  19. Paterno S.A., Lachiewicz P.F., Kelley S.S. The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement. J. Bone Joint Surg. (Am). 1997; 79:1202-1210.
  20. Perka C. The German experience with large diameter heads. In: Proceedings of annual meeting of AAOS. 2007:44.
  21. Sanchez-Sotelo J., Berry D.J. Instability after major joint replacement: epidemiology of instability after total hip replacement. Orthopedic Clinics of North America. 2001; 32(4):543-552.
  22. Smith T.M., Berend K.R., Lombardi A.V. Jr., Emerson R.H., Mallory T.H. Metal-on-metal total hip arthroplasty with large heads may prevent early dislocation. Clin. Orthop. 2005; (441):137-142.
  23. Stahelin T., Drittenbass L., Hersche O., Miehlke W., Munzinger U. Failure of capsular enhanced short external rotator repair after total hip replacement. Clin. Orthop. 2004; (420):199-204.
  24. Tsai S.J., Chen T.W., Jiang C.C. The effect of posterior capsule repair upon post-operative hip dislocation following primary total hip arthroplasty. BMC Musculoskeletal Disorders. 2008; 9:29.
  25. Wetters N.G., Murray T.G., Moric M., Sporer S.M., Paprosky W.G., Della Valle C.J. Risk factors for dislocation after revision total hip arthroplasty. Clin. Orthop. 2013; 471(2):410-416.
  26. Woolson S.T., Rahimtoola Z.O. Risk factors for dislocation during the first three months after primary total hip replacement. J. Arthroplasty. 1999; 14:662-668.

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