Dislocation after total hip arthroplasty: risk factors and treatment options

Abstract

To prevent redislocations after the first occurrence, we suggest thorough evaluation of possible technical faults which should be addressed surgically. Considering the high redislocation rate, we also advocate a stringent conservative treatment regime especially after the first THA dislocation.

Author’s reply

“…In a study with a larger population without standardized measurement, almost 50% of dislocated in total hip arthroplasty (THA) had high anteversion or inclination,7 but other studies could not confirm these results 8. These inconsistencies may be caused by different and imprecise radiographic measurement methods.In the control match study, matched with the dislocated patients for age, preoperative diagnosis, operative approach, and surgical site by Leichtle et al .,3 most acetabular cups were within the “safe zone”, without any significant difference between patients with or without dislocation. Therefore, no acetabular cup position gave full protection against dislocation.…”

“…In the control match study, matched with the dislocated patients for age, preoperative diagnosis, operative approach, and surgical site by Leichtle et al .,3 most acetabular cups were within the “safe zone”, without any significant difference between patients with or without dislocation. Therefore, no acetabular cup position gave full protection against dislocation.…”

“…Even if we look at the literature, no consensus on the contribution of sex as an independent risk factor has been reached3…”

Head size and dislocation rate in primary total hip arthroplasty

“…However, the demographic profile of the two groups was not sex-matched; female-to-male ratio between groups A and B was 0.37 and 0.68, respectively. According to the literature, female gender is associated with a higher dislocation rate;234 so was this a contributing factor in causing increased dislocation rate in group B (28 mm group)According to the authors, the etiology of dislocation (one in group A and three in group B) was component malposition. While component malposition itself is an independent risk factor for dislocation,45 is it justifiable to consider head size as the only factor when other confounding factors are also present…”

“…However, the demographic profile of the two groups was not sex-matched; female-to-male ratio between groups A and B was 0.37 and 0.68, respectively. According to the literature, female gender is associated with a higher dislocation rate;234 so was this a contributing factor in causing increased dislocation rate in group B (28 mm group)…”