Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery
Abstract Background There are many therapeutic options for dislocation following total hip arthroplasty (THA). The aim of this study was to evaluate the results of revision surgery for dislocated hips. Methods Between November 2001 and December 2020, 71 consecutive revision hip surgeries were perfor...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06355-4 |
| _version_ | 1797854047246483456 |
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| author | Takashi Toyoda Kenichi Oe Hirokazu Iida Tomohisa Nakamura Naofumi Okamoto Takanori Saito |
| author_facet | Takashi Toyoda Kenichi Oe Hirokazu Iida Tomohisa Nakamura Naofumi Okamoto Takanori Saito |
| author_sort | Takashi Toyoda |
| collection | DOAJ |
| description | Abstract Background There are many therapeutic options for dislocation following total hip arthroplasty (THA). The aim of this study was to evaluate the results of revision surgery for dislocated hips. Methods Between November 2001 and December 2020, 71 consecutive revision hip surgeries were performed at our institution for recurrent dislocation following THA. We conducted a retrospective study of all 65 patients (71 hips), who were followed for a mean of 4.7 ± 3.2 years (range, 1–14). The cohort included 48 women and 17 men, with a mean age of 71 ± 12.3 years (range, 34–92). The mean number of previous surgeries was 1.6 ± 1.1 (range, 1–5). From intraoperative findings, we created six categories of revision hip surgery for recurrent dislocation following THA: open reduction and internal fixation (2 hips); head change or liner change only (6 hips); cup change with increased head size only (14 hips); stem change only (7 hips); cup and stem change (24 hips); and conversion to constrained cup (18 hips). Prosthesis survival was analyzed by the Kaplan-Meier method, with repeat revision surgery for re-dislocation or implant failure as the endpoint. A cox proportional hazards model was used for risk factors of re-revision surgery. Results Re-dislocation occurred in 5 hips (7.0%) and implant failure in 1 hip (1.4%). The 10-year survival rate was 81.1% (95% confidence interval, 65.5–96.8). A Dorr classification of “positional” was a risk factor for re-revision surgery due to re-dislocation. Conclusion Clear understanding of the cause of dislocation is essential for optimizing revision procedures and improving the rate of successful outcomes. |
| first_indexed | 2024-04-09T20:00:45Z |
| format | Article |
| id | doaj.art-4f33561aaaca4865a50632b164905f52 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-09T20:00:45Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4f33561aaaca4865a50632b164905f522023-04-03T05:13:30ZengBMCBMC Musculoskeletal Disorders1471-24742023-03-0124111010.1186/s12891-023-06355-4Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgeryTakashi Toyoda0Kenichi Oe1Hirokazu Iida2Tomohisa Nakamura3Naofumi Okamoto4Takanori Saito5Department of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityDepartment of Orthopaedic Surgery, Kansai Medical UniversityAbstract Background There are many therapeutic options for dislocation following total hip arthroplasty (THA). The aim of this study was to evaluate the results of revision surgery for dislocated hips. Methods Between November 2001 and December 2020, 71 consecutive revision hip surgeries were performed at our institution for recurrent dislocation following THA. We conducted a retrospective study of all 65 patients (71 hips), who were followed for a mean of 4.7 ± 3.2 years (range, 1–14). The cohort included 48 women and 17 men, with a mean age of 71 ± 12.3 years (range, 34–92). The mean number of previous surgeries was 1.6 ± 1.1 (range, 1–5). From intraoperative findings, we created six categories of revision hip surgery for recurrent dislocation following THA: open reduction and internal fixation (2 hips); head change or liner change only (6 hips); cup change with increased head size only (14 hips); stem change only (7 hips); cup and stem change (24 hips); and conversion to constrained cup (18 hips). Prosthesis survival was analyzed by the Kaplan-Meier method, with repeat revision surgery for re-dislocation or implant failure as the endpoint. A cox proportional hazards model was used for risk factors of re-revision surgery. Results Re-dislocation occurred in 5 hips (7.0%) and implant failure in 1 hip (1.4%). The 10-year survival rate was 81.1% (95% confidence interval, 65.5–96.8). A Dorr classification of “positional” was a risk factor for re-revision surgery due to re-dislocation. Conclusion Clear understanding of the cause of dislocation is essential for optimizing revision procedures and improving the rate of successful outcomes.https://doi.org/10.1186/s12891-023-06355-4CementConstrained cupDislocationRevisionTotal hip arthroplasty |
| spellingShingle | Takashi Toyoda Kenichi Oe Hirokazu Iida Tomohisa Nakamura Naofumi Okamoto Takanori Saito Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery BMC Musculoskeletal Disorders Cement Constrained cup Dislocation Revision Total hip arthroplasty |
| title | Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery |
| title_full | Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery |
| title_fullStr | Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery |
| title_full_unstemmed | Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery |
| title_short | Treatment strategies for recurrent dislocation following total hip arthroplasty: relationship between cause of dislocation and type of revision surgery |
| title_sort | treatment strategies for recurrent dislocation following total hip arthroplasty relationship between cause of dislocation and type of revision surgery |
| topic | Cement Constrained cup Dislocation Revision Total hip arthroplasty |
| url | https://doi.org/10.1186/s12891-023-06355-4 |
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