Format

Send to

Choose Destination
See comment in PubMed Commons below
Clin Orthop Relat Res. 2012 Feb;470(2):482-9. doi: 10.1007/s11999-011-2101-x.

Is an algorithmic approach to the treatment of recurrent dislocation after THA effective?

Author information

  • 1University of California San Francisco School of Medicine, San Francisco, CA, USA.

Abstract

BACKGROUND:

The indications for surgical techniques for treatment of recurrent hip dislocation after THA differ, and their rates of achievement of stability may not be similar.

QUESTIONS/PURPOSES:

We (1) describe our indications for different approaches for recurrent dislocation, (2) outline an algorithmic approach to the management of recurrently dislocating hips after THA, and (3) determine the overall rate of restoration of stability via this algorithmic approach and for each of four procedures with our indications.

PATIENTS AND METHODS:

We retrospectively reviewed 66 patients (69 hips) with revision THA for symptomatic recurrent dislocation from 1993 to 2008. We determined the rate of achievement of stability for the overall patient population and with each revision technique. Minimum followup was 2.8 years (mean, 7.8 years; range, 2.8-12.7 years).

RESULTS:

Fifty-one of the 69 hips (74%) had no further dislocations while nine (13%) required two revisions and nine (13%) required three or more revisions. Ultimately, all of the 69 hips (100%) were stable at followup. Use of a large (36-mm-diameter) head, constrained cup, trochanteric advancement, correction of malposition, and a combination of techniques was effective in achieving stability in 67%, 68%, 86%, 91%, and 90% of cases, respectively.

CONCLUSIONS:

Separating the treatment of patients based primarily on the presence or absence of (1) component malposition, (2) an intact abductor mechanism, and (3) implants accommodating a large-diameter femoral head, we were able to achieve hip stability with one operation in 74% of cases.

LEVEL OF EVIDENCE:

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

[PubMed - indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk