Posterior Capsular Repair Following Total Hip Arthroplasty: A Modified Technique

Osmani, Omar; Malkani, Arthur L.

doi:10.3928/0147-7447-20040601-10

Cited by 21 publications

(10 citation statements)

References 6 publications

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“…The surgical technique consisted of a standard posterior approach with a pos-terior capsular repair. 11 The femoral and acetabular components used in all cases were the Accolade TMZF (Stryker) femoral stem and the Trident Acetabular Shell (Stryker) and all components were uncemented. All patients received either a 32mm (33 patients) or a 36-mm (27 patients) cobalt-chromium head.…”

Section: Methodsmentioning

confidence: 99%

Wear Analysis of Second-generation Highly Cross-Linked Polyethylene in Primary Total Hip Arthroplasty

Samujh¹,

Bhimani²,

Smith³

et al. 2016

Orthopedics

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A major limiting factor in the longevity of total hip replacement is the wear rate of the hip bearing. As manufacturing technology has improved during the past several decades, much attention has been focused on developing newer generations of polyethylene that have lower rates of wear while minimizing free radical formation and subsequent osteolysis. The turning point for the manufacture of polyethylene was moving from gamma irradiation in air to irradiation in a low oxygen environment, which reduced free radical formation while increasing the wear resistance. New polyethylene manufacturing methods, including multiple cycles of irradiation and annealing, have resulted in greater wear resistance. Wear analysis studies are essential to determine if these new liners actually show a benefit from prior generations of polyethylene and, more importantly, if they are safe to use. This study involved a single center retrospective review of 60 patients with a mean follow-up of 5.5 years who underwent primary total hip arthroplasty with a second-generation highly cross-linked polyethylene manufactured by 3 cycles of sequential irradiation and annealing. Linear and volumetric wear rates were determined from digitized radiographs using contemporary wear analysis software. The mean linear wear rate for the entire group was 0.025 millimeters per year (mm/y). This value represents a linear wear rate 2.7 times less than that of a first-generation highly cross-linked polyethylene and 4.2 times less than that of a conventional polyethylene. At an average of 5 years, compared with a first-generation highly cross-linked polyethylene, a second-generation highly cross-linked polyethylene appears to show significant improvement regarding wear. [Orthopedics. 2016; 39(6):e1178-e1182.].

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Section: Methodsmentioning

confidence: 99%

Wear Analysis of Second-generation Highly Cross-Linked Polyethylene in Primary Total Hip Arthroplasty

Samujh¹,

Bhimani²,

Smith³

et al. 2016

Orthopedics

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show abstract

“…A number of different posterior repair techniques have been described in the literature. Some authors have advocated releasing the capsule and the overlying external rotators as a single layer [5]. The rational behind this technique is that a thicker tissue sleeve will improve the quality of the repair.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Drill holes in the greater trochanter to anchor the repair have been associated with a 0.9% incidence of greater trochanter fracture [6]. This risk can be minimized by using a 2.3-mm or a 2.0-mm drill bit instead of a 2.7-mm drill [5]. The senior author has performed more than 5,000 THA and has not encountered this complication.…”

Section: Surgical Techniquementioning

confidence: 99%

Review: Posterior Soft Tissue Repair in Primary Total Hip Arthroplasty

Böttner

Pellicci

2006

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…This reduction in dislocation with the posterior approach is likely related both to an improved surgical technique and implant design, specifically, achievement of an appropriate combined anteversion, larger femoral heads and improved offset options, and inclusion of a posterior capsular repair [ 4 , [8] , [9] , [10] ]. There are multiple variations of posterior capsule repair described, but the differences can be broken down to soft tissue–only repairs or repair of the soft tissues to the greater trochanter [ 4 , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] ]. Therefore, the purpose of this study was to evaluate the dislocation rate of 2 posterior capsule repair techniques after primary THA: the first being a posterior capsule repair to the greater trochanter using a bone tunnel and the second being a side-to-side posterior capsular (direct soft tissue) repair.…”

Section: Introductionmentioning

confidence: 99%

A Specific Capsular Repair Technique Lowered Early Dislocations in Primary Total Hip Arthroplasty Through a Posterior Approach

Hernandez

Steele

et al. 2020

Arthroplasty Today

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Background: Dislocation is a challenging problem after total hip arthroplasty (THA). We sought to evaluate the incidence of early dislocation with 2 different posterior repair techniques after THA using a posterior approach. Methods: From September of 2008 to August of 2019, we evaluated 841 THAs performed by a single surgeon using a posterior approach. Before November of 2015, the capsule was repaired to the greater trochanter (group 1, 605 patients). Starting November 2015, the posterior capsule was repaired in a sideto-side fashion (direct soft-tissue repair) (group 2, 236 patients). There was a mean follow-up of 31.1 months (range, 2.5-122.5 months). A multivariable logistic regression model was constructed to assess the impact of baseline patient and operative factors on the dislocation rate. Results: There were 22 dislocations, all of which occurred in group 1. There were no dislocations in group 2. After adjusting for patient and operative factors, the direct soft-tissue repair had a large impact on the overall multivariable model as indicated by its effect likelihood ratio of 10.33 (P ¼ .001); however, the odds ratio was not calculable for this factor, given that there were no dislocations in hips with direct softtissue repair. Increasing age was associated with an increased odds of dislocation (odds ratio, 1.04, P ¼ .017), with an effect likelihood ratio of 6.25 (P ¼ .012). Conclusions: Switching from a capsular repair to the greater trochanter to a side-to-side capsular repair was associated with a decreased rate of dislocation in primary THA through a posterior approach.

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Posterior Capsular Repair Following Total Hip Arthroplasty: A Modified Technique

Abstract: Our modified posterior approach to total hip arthroplasty offers excellent fixation of the hip capsule on the greater trochanter, therefore minimizing the incidence of postoperative dislocation following THA.

Cited by 21 publications

References 6 publications

Wear Analysis of Second-generation Highly Cross-Linked Polyethylene in Primary Total Hip Arthroplasty

Wear Analysis of Second-generation Highly Cross-Linked Polyethylene in Primary Total Hip Arthroplasty

Review: Posterior Soft Tissue Repair in Primary Total Hip Arthroplasty

A Specific Capsular Repair Technique Lowered Early Dislocations in Primary Total Hip Arthroplasty Through a Posterior Approach

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