What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips

Fessy, Michel‐Henri; Putman, Sophie; Viste, Anthony; Isida, Ronald; Ramdane, Nassima; Ferreira, A.; Léglise, A.; Rubens-Duval, Brice; Bonin, Nicolas; Bonnomet, F.; Combes, A.; Boisgard, Stéphane; Mainard, Didier; Leclercq, S.; Migaud, Henri

doi:10.1016/j.otsr.2017.05.014

Cited by 125 publications

(66 citation statements)

References 30 publications

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“…[6][7][8][9][10][11] More than half of dislocations occur in the first three months following primary THR. [12][13][14] As the population ages and with growing volumes of primary THR, it is estimated that there will be a proportionate rise in the number of complications and revisions, 15,16 including revision for dislocations. Dislocation can result in severe pain, restriction of mobility, recurrent dislocation, and poor quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for dislocation after primary total hip replacement: a systematic review and meta-analysis of 125 studies involving approximately five million hip replacements

Kunutsor

Barrett

Beswick

et al. 2019

The Lancet Rheumatology

109

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Section: Introductionmentioning

confidence: 99%

“…table 1; appendix pp[11][12][13][14][15][16][17][18][19][20].The 125 unique studies comprised of 116 (92.8%) observational designs and 9 (7.2%) RCTs.Publication dates of included studies ranged from 1975 to 2019. A summary of the key characteristics of eligible studies is presented in table 1.…”

mentioning

confidence: 99%

Risk factors for dislocation after primary total hip replacement: a systematic review and meta-analysis of 125 studies involving approximately five million hip replacements

Kunutsor

Barrett

Beswick

et al. 2019

The Lancet Rheumatology

109

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show abstract

“…Factors associated with higher dislocation rates post-THA are small head size; femoral component malpositioning; cup inclination outside Lewinnek`s safe zone (30°-50°); inappropriate anteversion; unrepaired joint capsule; lowvolume surgeon; and patient-specific factors such as neurological deficits (dementia, Parkinson disease), high ASA score, history of spinal fusion, abductor deficiency, body mass index > 35 kg/m 2 , and preoperative Harris Hip Score < 41 [5,[7][8][9][10][11]. Despite lower dislocation rates, BHA is associated with higher periprosthetic fracture rates most likely because of lower bone quality [1,3,4,8,[12][13][14]. Owing to higher patients' satisfaction with THA than HA in case of displaced femoral neck fractures, the former is recommended in patients aged < 80 years and with a life expectancy of > 4 years.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for dislocation after bipolar hemiarthroplasty: a retrospective case–control study of patients with CT data

Graulich

Graeff

Jaiman

et al. 2020

Eur J Orthop Surg Traumatol

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Purpose Bipolar hemiarthroplasty has been shown to have a lower rate of dislocation than total hip arthroplasty. However, as the influencing risk factors for bipolar hemiarthroplasty dislocation remain unclear, we aimed to analyse patient and surgeon-specific influencing risk factors for bipolar hemiarthroplasty dislocation. Methods We retrospectively analysed patients who were operated between 2012 and 2018 and had dislocated bipolar hemiarthroplasty and matched them to patients without a dislocated bipolar hemiarthroplasty, operated between 2018 and 2019. The study was limited to patients who received either a pre- or postoperative pelvic computed tomography. Besides demographic, morphologic, and physiologic data, we analysed duration of surgery; ASA score; Charlson Comorbidity Index; Almelo Hip Fracture Score; Parker Score; and acetabular morphology angles including acetabular anteversion angle, posterior acetabular sector angle, posterior wall angle, and acetabular roofing. Results We included nine patients with a dislocated bipolar hemiarthroplasty and 30 with a non-dislocated bipolar hemiarthroplasty. Patient-specific factors prompting a higher risk for dislocated bipolar hemiarthroplasty were longer duration of surgery (min) (115 ± 50 vs. 80 ± 27, p = 0.01); dementia (56% vs. 13%, p < 0.01); smaller posterior acetabular sector angle (°) (96 ± 6 vs. 109 ± 10, p < 0.01); and smaller posterior wall angle (°) (67 ± 6 vs. 77 ± 10, p = 0.02). Conclusion Dementia and insufficient posterior wall angle were associated with higher risk of dislocation in bipolar hemiarthroplasty

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“…Reports on increased length of stay, non-routine discharge, perioperative morbidity, periprosthetic infection rate, risk of falling and perioperative bleeding are all causes for concern. Furthermore, psychiatric patient may have a potential risk of postoperative artificial joint dislocation [14]. Gylvin et al described that pre-existing psychological factors have an effect on the outcome of arthroplasty and appropriate strategies might be needed [15].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Total Hip Arthroplasty to a Patient Associated with Alcoholic Cirrhosis and Severe Plated Deficiency with Preoperative Partial Splenic Embolization

Yamanaka¹,

Nakano²,

Nakayama³

et al. 2018

TOORTHJ

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Introduction: We present the first report of the successful treatment of Total Hip Arthroplasty (THA) to a patient associated with alcoholic cirrhosis and plated deficiency undergoing preoperative Partial Splenic Embolization. Case Report: A 45-year woman who had Liver Cirrhosis (LC) and alcohol residue heritage failure suffered from severe groin pain and had a difficulty in walking for a long period due to avascular necrosis of bilateral femoral head. She was referred to our orthopaedic service and THA was planned. Despite preoperative transfusion for her platelet deficiency coursed by LC, preoperative platelet count decreased less than a normal range. Therefore, Partial Splenic Embolization (PSE) was applied to her so as to increase platelet count. PSE could temporally reduce the portal vein pressure and prevent a hyperspleism and cytopenia. After the procedure, THA was performed to bilateral hip safely through a direct anterior approach. At the time of the latest follow-up, the patient had an excellent clinical result. Conclusion: Preoperative PSE may be a useful procedure to the patients with LC and severe plated deficiency who need arthroplasty including THA. Pre-existing physical and psychological factors have an effect on the outcome of arthroplasty and appropriate strategies might be needed.

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What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips

Abstract: Level III; case-control study.

Cited by 125 publications

References 30 publications

Risk factors for dislocation after primary total hip replacement: a systematic review and meta-analysis of 125 studies involving approximately five million hip replacements

Risk factors for dislocation after primary total hip replacement: a systematic review and meta-analysis of 125 studies involving approximately five million hip replacements

Risk factors for dislocation after bipolar hemiarthroplasty: a retrospective case–control study of patients with CT data

Successful Treatment of Total Hip Arthroplasty to a Patient Associated with Alcoholic Cirrhosis and Severe Plated Deficiency with Preoperative Partial Splenic Embolization

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