Total hip replacement through a posterior approach using a 22 mm diameter femoral head

Kumar, Vishwajeet; Sharma, S; James, J.; Hodgkinson, J.P.; Hemmady, Mukesh

doi:10.1302/0301-620x.96b9.31831

Cited by 18 publications

(11 citation statements)

References 35 publications

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“…13 causes for dislocation, regardless of the idoneity of the cup position, a finding also reported by others [7,24,32]. We also observed that the lever arm distance and the height of the greater trochanter differed among the different designs, which may also affect the differences observed in the rates of dislocation.…”

Section: Accepted Manuscriptsupporting

confidence: 86%

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Abductor Biomechanics Clinically Impact the Total Hip Arthroplasty Dislocation Rate

García-Rey

García-Cimbrelo

2016

The Journal of Arthroplasty

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Section: Accepted Manuscriptsupporting

confidence: 86%

“…THA, with a 22.225 mm diameter femoral head operated through a posterior approach with a capsule repair, was associated with a low rate of dislocation [24]. They do not support the idea of using large-diameter heads since data from Registries and wear problems are being reported.…”

Section: Accepted Manuscriptmentioning

confidence: 92%

Abductor Biomechanics Clinically Impact the Total Hip Arthroplasty Dislocation Rate

García-Rey

García-Cimbrelo

2016

The Journal of Arthroplasty

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“…Blumenfeld and Bargar hypothesized that increasing the femoral head diameter and revising the liner of a recurrently dislocating THR will not always be successful [24]. Therefore, a larger femoral head does not ensure stability and increasing the size of the femoral head is not the only way to reduce the rate of dislocation; optimal alignment of the components and repair of the posterior capsule could achieve a similar effect [25].…”

Section: Discussionmentioning

confidence: 99%

“…Certain centers are still using a 22-mm head with a high success and low dislocation rate in primary hip replacement [25,29] and for example, the Norwegian Arthroplasty Register showed a higher number of hip replacements with a 22-mm head than any other head size [30]. Also, Dutch Arthroplasty Register showed that femoral head sizes of 22 to 28 mm and 32 mm had a comparable risk of revision for any reason except dislocation, while 36-mm femoral head THAs had a 16% increased risk [31].…”

Section: Discussionmentioning

confidence: 99%

Conversion of Failed Hip Hemiarthroplasty to Low Friction Arthroplasty (LFA)

Bayam

Drampalos

Nagai

et al. 2019

JCM

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Purpose: We aimed to study clinical and radiological outcomes of conversion from hemiarthroplasty to Charnley hip replacement (CHR) with a particular concern over reported increased dislocation rate and literature review. Conversion of hip hemiarthroplasty to total hip replacement (THR) is a procedure reported to have high rates of complications. In the literature, there is no specific study on small head conversion. The purpose of this study was to evaluate the conversion of failed hip hemiarthroplasty to CHR with the use of modern implants. Methods: The study included 42 patients, who underwent the above procedure. The operations were carried out using a modern Charnley-type THR with a 22-mm diameter of femoral head and a trans-trochanteric approach. The mean follow-up was 75.7 months (range 25–171). Radiographs from the last follow up were evaluated for loosening and other reasons of failure. Clinical outcome was assessed using postoperative pain, function scores, complications and implant survivorship as well as radiological evaluation. Charnley’s modified pain and mobility scoring system were used for clinical and Hodgkinson and Harris’ criteria were used for radiological assessment. Results: Functionally, all of the patients showed improvement. Mean improvement in the pain level was by average of 2.4. On mobility assessment, 38 patients (90.4%) improved. Three patients (7.1%) had recurrent infections and three (4.8%) cases were treated with revision surgery and pseudarthrosis. Further complications occurred in 19.1%, not requiring operative treatment. On radiological evaluation, one (2.4%) case showed cup demarcation without bone loss, two (4.8%) cup migration, and one (2.4%) stem demarcation. Kaplan Meier survival analysis showed a survival of 90% at 96 months of follow up (95% CI (confidence interval), 60–90). Conclusion: Larger head might not be the answer to decrease the dislocation rate. Complication rates during revision of hip hemiarthroplasty to modern CHR with 22.225-mm head diameter were comparable to first-time THR revision despite having a smaller head.

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“…Conversely, PA has generally been associated with higher dislocation rates of 1.7%–5.3% 404142. Although recent literature has demonstrated improved stability with posterior capsular repairs 42434445. Randomized prospective data on dislocations is lacking, but several meta analyses and large retrospective comparative studies have demonstrated stability superiority with the anterior based approaches versus PA 344647484950.…”

Section: Discussionmentioning

confidence: 99%

Surgical Approaches for Total Hip Arthroplasty

Moretti

Post

2017

IJOO

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Total hip arthroplasty (THA) has become one of the most reliable and patient-requested surgical interventions in all medicine. The procedure can be performed using a variety of surgical approaches, but the posterior approach, direct lateral approach, and direct anterior approach are by far the most common across the globe. This article highlights the history and technique for each of these common approaches. A review of outcomes and complications for each approach are also provided. Each approach has its own unique advantages and disadvantages, but all can be safely and successful utilized for THA. Strong, convincing, high-quality studies comparing the different approaches are lacking at this time. Surgeons are therefore recommended to choose whichever approach they are most comfortable and experienced using. Though not described here, THA can also be done using the anterolateral approach (also known as the Watson Jones approach) as well as the two-incision approach. In addition, recently, some surgeons are utilizing the so-called direct superior approach for THA. While these approaches are far less commonly utilized, they are recognized as viable alternatives to traditional approaches.

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Total hip replacement through a posterior approach using a 22 mm diameter femoral head

Cited by 18 publications

References 35 publications

Abductor Biomechanics Clinically Impact the Total Hip Arthroplasty Dislocation Rate

Abductor Biomechanics Clinically Impact the Total Hip Arthroplasty Dislocation Rate

Conversion of Failed Hip Hemiarthroplasty to Low Friction Arthroplasty (LFA)

Surgical Approaches for Total Hip Arthroplasty

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