Dislocation After Total Hip Arthroplasty Among Patients With Developmental Dysplasia of the Hip

Wang, Liao; Trousdale, Robert T.; Ai, Songtao; An, Kai Nan; Dai, Kerong; Morrey, B.F.

doi:10.1016/j.arth.2011.08.021

Cited by 39 publications

(25 citation statements)

References 23 publications

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“…The dislocation rate after total hip arthroplasty (THA) is influenced by the diagnosis and the medical condition of the patient (Wang et al 2012), the surgical approach (Berry et al 2005), femoral head size (Byström et al 2003, Jameson et al 2011, Wang et al 2012), and the skills of the surgeon through component positioning (Witjes et al 2009). Recurrent dislocation is one of the most common reasons for reoperations in THA (Byström et al 2003).…”

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confidence: 99%

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Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty

et al. 2013

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Background and purpose Previous population-based registry studies have shown that larger femoral head size is associated with reduced risk of revision for dislocation. However, the previous data have not included large numbers of hip resurfacing arthroplasties or large metal-on-metal (> 36-mm) femoral head arthroplasties. We evaluated the association between femoral component head size and the risk of revision for dislocation after THA by using Finnish Arthroplasty Register data.Patients and methods 42,379 patients who were operated during 1996–2010 fulfilled our criteria. 18 different cup/stem combinations were included. The head-size groups studied (numbers of cases) were 28 mm (23,800), 32 mm (4,815), 36 mm (3,320), and > 36 mm (10,444). Other risk factors studied were sex, age group (18–49 years, 50–59 years, 60–69 years, 70–79 years, and > 80 years), and time period of operation (1996–2000, 2001–2005, 2006–2010).Results The adjusted risk ratio in the Cox model for a revision operation due to dislocation was 0.40 (95% CI: 0.26–0.62) for 32-mm head size, 0.41 (0.24–0.70) for 36-mm head size, and 0.09 (0.05–0.17) for > 36-mm head size compared to implants with a head size of 28 mm.Interpretation Larger femoral heads clearly reduce the risk of dislocation. The difference in using heads of > 36 mm as opposed to 28-mm heads for the overall revision rate at 10 years follow-up is about 2%. Thus, although attractive from a mechanical point of view, based on recent less favorable clinical outcome data on these large heads, consisting mainly of metal-on-metal prostheses, one should be cautious using these implants.

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confidence: 99%

“…Small femoral head size is a risk factor for dislocation (Byström et al 2003, Jameson et al 2011, Wang et al 2012). Hip implants with larger femoral heads have been developed to reduce the dislocation rate.…”

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Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty

et al. 2013

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“…Moreover, the anteversion angle of the acetabular cup needed to be set less than normal. Although no significant correlation was found between post-operative dislocation of the prosthesis and its anteversion angle, we agree with the author that managing combined anteversion angle of the cup and stem into the range from 30 to 45°would decrease the risk of post-operative dislocation [4]. Overcorrection of anteversion that causes posterior hip dislocation should be avoided especially for those with bilateral hip dysplasia which is usually combined with excessive lumbar lordosis.…”

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confidence: 45%

Reply to comment on Bao et al.: Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip

Bao

Zhao

2013

International Orthopaedics (SICOT)

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“…Complete deficiency of entire acetabulum with excessive anteversion metal-on-polyethylene has the longest follow-up data, but due to the typically young age of patients undergoing THA for DDH, ceramic-on-polyethylene is now most often used due to the improved material wear properties [17]. Dual-mobility cups may improve stability, but recent literature demonstrates that the dislocation rate of THA for DDH is comparable to the dislocation rate of THA for OA [18]. In Wang et al's series of 820 hips undergoing THA for DDH, the dislocation rate was reported at 2.93%, and the key factor in dislocation risk was a femoral head size of 28 mm (as opposed to 32 mm), illustrating the importance of using an adequately sized cup-head combination.…”

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Total hip arthroplasty in an adult patient with pelvic dysmorphism, unilateral sacroiliac joint autofusion, and developmental hip dysplasia

et al. 2020

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a b s t r a c tThis case describes the challenges associated with total hip arthroplasty in a patient with unique anatomy, including developmental dysplasia of the hip, pelvic dysmorphism, and unilateral sacroiliac joint autofusion. A 30-year-old female, with a history of developmental dysplasia of the hip treated with presumed pelvic osteotomy complicated by postoperative infection, presented with hip pain refractory to conservative management. Radiographic studies demonstrated a 10-cm leg length discrepancy, 20 of acetabular retroversion, severe hemipelvic dysmorphism, ipsilateral sacroiliac joint autofusion, and significant femoral head dysplasia. Total hip arthroplasty was performed using a revision acetabular component and modular femoral component, resulting in improvement in the postoperative leg length discrepancy. There were no neurovascular or other perioperative complications, and the patient was ambulating without pain or assistive devices at 1-year follow-up.

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Dislocation After Total Hip Arthroplasty Among Patients With Developmental Dysplasia of the Hip

Cited by 39 publications

References 23 publications

Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty

Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty

Reply to comment on Bao et al.: Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip

Total hip arthroplasty in an adult patient with pelvic dysmorphism, unilateral sacroiliac joint autofusion, and developmental hip dysplasia

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