The incidence of hip dislocation after posterior approach primary total hip arthroplasty: comparison of two different posterior repair techniques

Dimentberg, Evan; Barimani, Bardia; Alqahtani, M; Tayara, B; Belzile, Éric; Albers, Alexander

doi:10.1007/s00402-022-04609-9

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…This could be treated with capsule closure. This is in keeping with previous studies, which found that soft tissue-tobone repair in the posterior hip joint capsules resulted in dislocation occurring less often than soft tissue-to-soft tissue repair or non-repair (24)(25)(26) . The same result was seen in anterior capsule repair (27) .…”

Section: Discussionsupporting

confidence: 92%

“…Two suture methods, soft tissue-to-soft tissue, and soft tissueto-bone, were used for both the anterior and posterior capsules. Studies have found that posterior capsule soft tissue-to-bone repair results in fewer dislocations than soft tissue-to-soft tissue repair or no repair (24)(25)(26) , and the same result was found in anterior capsule repair (27) . When the posterior approach was compared to the anterior approach regarding treatment outcomes and postoperative complications, there were no significant differences (12,13) .…”

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confidence: 82%

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Hip Capsular Repair Affect on Joint Laxity in Total Hip Arthroplasty

Boonruksa,

Ruangthong

2024

JseaOrtho

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Purpose: Loss of tissue tension around the hip is a cause of hip dislocation. The shuck test is a simple intraoperative test for soft tissue tension. This study evaluated the soft tissue tightness around the hip joint after capsule repair and compared the joint tension resulting from different capsule repair approaches. Methods: Fifty-three patients underwent a non-cemented total hip replacement using image-free computer-assisted surgery. The patients were divided into the posterior and the anterolateral approach groups. After the hip was reduce, a computer navigation plan was devise to restore proper leg length. The shuck test was applied to determine the soft tissue tension before and after capsule repair. The leg length was recorded after hip reduction and the shuck test. Data from the computer navigation were collected for analysis. Results The results of this study showed that after the shuck test, the leg length increased by up to 5.98±1.75 mm. (6.73±1.64 mm. and 5.26±1.56 mm for the posterior and anterolateral approach, respectively). After capsule repaire, the leg was shortened by 4.78±1.31 mm. (5.42±1.10 mm. and 4.15±1.20 mm for posterior and anterolateral approach, respectively). The study found that the leg shortening from the posterior approach was significantly higher than the anterolateral approach (p-value <0.001). There were no hip dislocations in this series. Conclusions: Hip capsule repair improves the soft tissue tension around the hip joint. This helps reduce the risk of hip dislocation. Hip capsule repair using a posterior approach has a better outcome.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 82%

Hip Capsular Repair Affect on Joint Laxity in Total Hip Arthroplasty

Boonruksa,

Ruangthong

2024

JseaOrtho

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“…Optimized implant positioning with restauration of femoral offset contributes to THA stability as well [ 28 , 29 ]. Recent studies have confirmed the importance of capsular repair; optimal stability is acquired with transosseous bone sutures, instead of capsular resection [ 30 , 31 ]. No difference was found between absorbable and non-absorbable sutures for this repair [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Did the dislocation risk after primary total hip arthroplasty decrease over time? A meta-analysis across six decades

Erp

Hüsken

Filipe

et al. 2022

Arch Orthop Trauma Surg

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Background While continuous optimization is attempted to decrease the incidence of dislocation after total hip arthroplasty (THA), dislocation remains a major complication. This meta-analysis aims to analyze the evolution of the dislocation risk after primary THA over the decades and to evaluate its potential publication bias. Patients and methods A systematic search was performed according to the PRISMA guidelines for this meta-analysis in the literature published between 1962 and 2020. MEDLINE, Cochrane and Embase databases were searched for studies reporting the dislocation risk and length of follow-up. Studies that reported on revision rates only and did not mention separate dislocations were excluded. All study designs were eligible. Study quality was assessed by existing quality assessment tools adjusted for arthroplasty research. Overall risk and yearly dislocation rates were calculated and related to historical time frame, study design, sample size and length of follow-up. Results In total, 174 studies were included with an overall moderate quality. In total there were 85.209 dislocations reported in 5.030.293 THAs, showing an overall dislocation risk of 1.7%, with a median follow-up of 24 months. The overall dislocation risk classified per decade decreased from 3.7% in 1960–1970 to 0.7% in 2010–2020. The yearly dislocation rate decreased from 1.8 to 0.7% within these same decades. There was no significant correlation between the reported dislocation risk and the duration of follow-up (p = 0.903) or sample size (p = 0.755). The reported dislocation risk was higher in articles with registry data compared to other study designs (p = 0.021). Conclusion The dislocation risk in THA has been decreasing over the past decades to 0.7%. Non-selective registry studies reported a higher dislocation risk compared to studies with selective cohorts and RCTs. This indicates that the actual dislocation risk is higher than often reported and ‘real-world data’ are reflected better in large-scale cohorts and registries.

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