A conservative approach to dislocation following total hip arthroplasty: a review of 8606 hips

Ogonda, Luke; Cassidy, Roslyn; Beverland, David

doi:10.1177/1120700020959062

Cited by 3 publications

(5 citation statements)

References 38 publications

(56 reference statements)

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“…Podobně jako jiní autoři jsme zjistili, že u tzv. pozičních luxací, kterých je nejvíce, je možné s výhodou postupovat konzervativně (12,22). Některá pracoviště řeší konzervativně nejen všechny primární luxace I. typu, ale i jejich první recidivu a k revizní operaci přistupují až při druhé recidivě (22).…”

Section: Diskuseunclassified

“…pozičních luxací, kterých je nejvíce, je možné s výhodou postupovat konzervativně (12,22). Některá pracoviště řeší konzervativně nejen všechny primární luxace I. typu, ale i jejich první recidivu a k revizní operaci přistupují až při druhé recidivě (22). Diskuse se vedou o optimálních režimových opatřeních, fyzioterapii a délce odlehčení zakloubené kyčle, protože se předpokládá, že při vykloubení dojde nejen k poškození pouzdra, ale současně i svalů zajišťujících dynamickou stabilitu kloubu.…”

Section: Diskuseunclassified

“…Někteří však považují nošení ortézy po zakloubení za zbytečné (21), jiní ji nepoužívají, protože podle nich není k přepokládanému účelu určená a místo toho nakládají na několik týdnů sádrovou spiku, resp. sádrovou objímku od třísla k hleznu (22). My sádrovou fixaci používáme pouze u nespolupracujících či jinak hendikepovaných pacientů.…”

Section: Diskuseunclassified

“…My pacientům doporučujeme až dvanáctitýdenní nošení ortézy v závislosti na individuální kompozici pacienta (u rizikových kyčlí i déle). Také jiní autoři chrání kyčel 12 týdnů od zakloubení (22), přestože pro tuto dobu neexistuje solidní opora v klinických studiích. Po repozici a nasazení ortézy se pacient rozchodí o berlích a posiluje pelvifemorální svaly a svaly kolenního kloubu.…”

Section: Diskuseunclassified

“…typu luxace až "časem" a tento typ byl tedy málo zastoupený u první luxace. Naopak minimální délka sledování 12 měsíců od poslední léčebné intervence vyhovuje primárnímu cíli terapie a používají ji i ostatní autoři (22). Z pohledu funkčních výsledků, resp.…”

Section: Diskuseunclassified

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How Does Affect the Type of Instability after Total Hip Arthroplasty the Outcomes? Our Experience between 1999 and 2020

Špička,

Gallo,

Langová

2023

ACHOT

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PURPOSE OF THE STUDYDislocation is one of the most common early complications of total hip arthroplasty (THA). In this manuscript, 20 years of experience with the management of this complication are presented, particularly in relation to the type of instability. MATERIAL AND METHODSIn the period between January 1999 and December 2020, at least one dislocation occurred in 157 of 8 286 (1.9%) THA patients, of which 117 dislocations (1.6%) in primary and 40 (3.4%) in revision THAs. Almost all patients were operated on from the anterolateral approach during the follow-up period. The type of dislocation was evaluated using the modified Dorr classification. In the first dislocations, conservative approach was usually opted for, except for cases with a clear malposition, irreducible or unstable hips after the reduction. The minimum follow-up period was 18 months (18-240). The success rate of the chosen treatment approach was assessed by means of standard statistical methods. RESULTSThe total dislocation rate in the follow-up period was 1.6% for primary THAs and 3.4% for revision THAs. The dislocation rate was slightly higher between 1999 and 2009 compared to the following decade (2.1% versus 1.3% for primary THAs; p=0.009). The most common type of dislocation was the positional dislocation (62%), followed by dislocations due to a combination of causes (17%) and component malposition (11%). Treatment of dislocation was successful in a total of 130 patients (130/157; 83%). Even though a stable hip was achieved in 21 patients (13%), the functional outcome was unsatisfactory, and in 6 patients (4%) we failed to achieve a stable hip.In the positional type of dislocation, the success rate of closed reduction following the first-time dislocation was 86.4% and a similar success rate was reported for reoperations in the first-time dislocations due to the malpositioned components (85.7%). In the second-time dislocation, the surgical therapy was significantly more reliable compared to closed reduction regardless of the type of dislocation (78.6% versus 46%). The treatment of dislocations following primary THAs showed comparable outcomes to those of the treatment of dislocations following revision THAs. Overall, the worst outcomes were achieved in patients with a combined type of dislocation. In total, the THA had to be removed in 11.5% of hips (18/157). The probability of final THA removal increased with the increasing order of dislocation. DISCUSSIONIn our group of patients, the dislocation rate in THA was comparable or lower than the published data. With the use of preventive measures, i.e. dual mobility cup or larger head diameters in high-risk patients, we managed to reduce the dislocation rate over time. The positional type of dislocation prevails in our group of patients just as in the previously published series, followed by instability from malposition of components. The modified Dorr classification is used to guide the treatment since it allows us not only to make good decision about the treatment modality but to some ext...

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Section: Diskuseunclassified

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How Does Affect the Type of Instability after Total Hip Arthroplasty the Outcomes? Our Experience between 1999 and 2020

Špička,

Gallo,

Langová

2023

ACHOT

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The Application Effect of Comprehensive Nursing on Hip Function and Psychological Status in Patients after Hip Replacement

王

2024

ACM

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Recurrent Dislocations of Bipolar Components: A Rare Complication of Bipolar Femoral Head Replacement

Zeng

et al. 2023

Preprint

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Prosthesis dislocation is considered one of rare complications after artificial femoral head arthroplasty. We present a case of the complication related to small head dislocation from the cup. This was a 70-year-old female with acute cerebral infarction patient undergoing three operative treatments after the femoral neck fracture within a short perioperative period. The dislocation was not resolved until the last revision of partial prosthetic components. Prosthetic components dislocation is rarely reported, yet it may cause open reduction once happened in patients. Special attention should be warranted to the implants and the special patients as they might suffer from the recurrent dislocation and be amenable to surgical treatment.

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A conservative approach to dislocation following total hip arthroplasty: a review of 8606 hips

Cited by 3 publications

References 38 publications

How Does Affect the Type of Instability after Total Hip Arthroplasty the Outcomes? Our Experience between 1999 and 2020

How Does Affect the Type of Instability after Total Hip Arthroplasty the Outcomes? Our Experience between 1999 and 2020

The Application Effect of Comprehensive Nursing on Hip Function and Psychological Status in Patients after Hip Replacement

Recurrent Dislocations of Bipolar Components: A Rare Complication of Bipolar Femoral Head Replacement

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