Dislocation of hip hemiarthroplasty following posterolateral surgical approach: a nested case–control study

Madanat, Rami; Mäkinen, Tuula; Ovaska, Mikko; Soiva, M.; Vahlberg, Tero; Haapala, Jussi

doi:10.1007/s00264-011-1353-0

Cited by 52 publications

(93 citation statements)

References 20 publications

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“…In the current study, another factor significantly associated with an increased risk of hip dislocation was discrepancy of offset; this could give rise to poor soft tissue tension and therefore contribute to the increased risk of dislocation. Other studies have found that lower offset was a risk factor for dislocation of unipolar hemiarthroplasty prostheses [14,18]. Mukka et al [17] reported that patients with single dislocations had no difference in postoperative femoral offset compared with age-and sex-matched control subjects, but there was a smaller femoral offset compared with offset in the patients with recurrent dislocations.…”

Section: Discussionmentioning

confidence: 98%

What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Li¹,

Ren²,

Liu³

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Hip dislocation after treatment of a femoral neck fracture with a hemiarthroplasty remains an important problem in the treatment of hip fractures, but the associations between patient factors and surgical factors, and how these factors contribute to dislocation in patients who have undergone bipolar hemiarthroplasty through an anterolateral approach for femoral neck fracture currently are only poorly characterized. Questions/purposes We evaluated patients with bipolar hemiarthroplasty dislocation after surgery for femoral neck fracture treated through an anterolateral approach and asked: (1) What are the frequency, characteristics, and risk factors of bipolar hemiarthroplasty dislocations? (2) What are the frequency, characteristics, and risk factors of bipolar hemiarthroplasty dissociations?

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Section: Discussionmentioning

confidence: 98%

What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Li¹,

Ren²,

Liu³

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Dislocation rates may be influenced by joint capsule reconstruction [10] and implant positioning [13]. Increased dislocation rates have also been found in patients after prolonged operative time [14]. The risk for haematoma on the other hand may be reduced by atraumatic soft tissue handling and meticulous bleeding control, which however may prolong operative time.…”

Section: Dorsal Vs Transgluteal Approach: From the Frying Pan Into Thmentioning

confidence: 99%

“…Following THA several studies showed a lower dislocation rate after the transgluteal approach compared to the dorsal approach [10][11][12][13][14]. Unfortunately most publications focus only on dislocation rate.…”

Section: Introductionmentioning

confidence: 99%

Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases

Biber

Brem

Singler³

et al. 2012

International Orthopaedics (SICOT)

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Purpose Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches. Methods We retrospectively analysed a cohort including 704 consecutive patients who received HA for femoral neck fracture; 212 male and 492 female patients were included, and the mean age was 80.4 years (SD 9.8 years). In 487 patients a dorsal and in 217 a transgluteal approach was chosen. In all patients an Excia® stem with selfcentring bipolar head manufactured by Aesculap (Tuttlingen, Germany) was used. We evaluated early postoperative complications including dislocation, infection, haematoma, seroma and perioperative fracture. Complication rates after dorsal and transgluteal approaches were calculated and compared by the chi-square test.Results After a dorsal approach 10.5 % [confidence interval (CI) 7.7-13.2 %] of the patients suffered one or more early complications. Following a transgluteal approach this proportion was 9.7 % (CI 5.7-13.6 %), which was not significantly different (p00.75). The predominant complication after a dorsal approach was dislocation (3.9 %; CI 2.2-5.6 %). The dislocation rate after a transgluteal approach was significantly lower (0.5 %; CI 0-1.4 %). Postoperative haematoma however was seen after a transgluteal approach in 5.5 % (CI 2.5-8.6 %), which was significantly more frequent than after a dorsal approach (1.2 %; CI 0.2-2.2 %). The frequency of the other types of complications did not significantly differ. Conclusions The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma.

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“…Prior to the publication of the current study, some earlier work suggests that dementia, difficulties with communication, decreased response to pain, and diminished ability to walk can increase the likelihood that dislocation might occur [3,14]. On the other hand, another recent study found no association between dislocation and mental status [7].…”

mentioning

confidence: 66%

“…Decreasing femoral offset and limb-length shortening may reduce muscle tension, decreases the length of the lever arm, and may induce impingement between prosthesis and acetabulum, leading to dislocation [7][8][9]. Recent publications [5,8] also found a high association between a low center-edge (CE) angle and dislocation.…”

mentioning

confidence: 99%

CORR Insights®: What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Mayr

2016

Clinical Orthopaedics &Amp; Related Research

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Dislocation of hip hemiarthroplasty following posterolateral surgical approach: a nested case–control study

Cited by 52 publications

References 20 publications

What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases

CORR Insights®: What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

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