Early dislocation in primary total hip arthroplasty using a posterior approach with repair of capsule and external rotators

Hernández, A.; Núñez, Jorge H.; Mimendia, Iñaki; Barro, Víctor; Azorin, L.

doi:10.1016/j.recote.2018.11.001

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…First, the small sample size produces statistical bias, and the patients with femoral neck fractures led to a high postoperative dislocation rate. Second, the follow-up time was short, and hip function improved over time, even though hip dislocation mostly occurred 120 days after surgery [ 37 ]. Third, a further study should be performed to better understand the kinematics of mesh reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Using mesh in capsule anatomical reconstruction to enhance the stability of high-dislocation-risk hip arthroplasty: a randomized controlled trial

Xin

et al. 2023

J Orthop Surg Res

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Background Dislocation is a common complication after total hip arthroplasty (THA). This study aimed to compare the outcomes of mesh reconstruction versus conventional capsular repair in maintaining capsular integrity and preventing dislocation after THA. Methods This was a prospective, randomized controlled study of consecutive patients. A total of 124 high-dislocation-risk THAs were identified and randomized into two groups, one using mesh reconstruction and the other using the conventional capsular repair method. Perioperative data and radiological data were collected. Patients were followed up regularly. The main indices were the capsular integrity assessed by magnetic resonance imaging (MRI) and hip dislocation rate. The secondary indices included the Harris hip score (HHS), complications, and satisfaction. Results A total of 106 patients completed the follow-up and the average follow-up times were 19 ± 3.1 and 18 ± 3.3 months. The operation time of the mesh group was longer than that of the conventional group (P < 0.001). There were minor differences in acetabular anteversion and abduction angle, and the other data showed no differences. MRI results indicated that the success rate of capsular repair was higher in the mesh group (50 hips, 98%) than in the conventional group (37 hips, 67%) (P < 0.001), and the others failed the repair. Three dislocations occurred in the conventional group, while none occurred in the mesh group. The preoperative HHS (30 points) and postoperative HHS (82 points) of the mesh group were similar to those (35 points, 83 points) of the conventional group (P = 0.164, P = 0.328). Satisfaction had no difference (P = 0.532). Conclusions Compared to conventional repair, mesh reconstruction can effectively maintain capsular integrity and decrease dislocation risk after THA without increasing complications. Level of evidence: Therapeutic study, Level IA.

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Section: Discussionmentioning

confidence: 99%

Using mesh in capsule anatomical reconstruction to enhance the stability of high-dislocation-risk hip arthroplasty: a randomized controlled trial

Xin

et al. 2023

J Orthop Surg Res

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show abstract

“…First, the small simple size produces statistical bias. Second, the follow-up time is too short, and hip function improves over time, even though hip dislocation mostly occurred with 120 days after surgery (37). Third, a further study should be performed to better understand the kinematics of mesh reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Using mesh in capsule anatomical reconstruction to enhance the stability of high- dislocation-risk hip arthroplasty: a randomized controlled trial

Xin

et al. 2022

Preprint

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Background: Dislocation is a common complication after total hip arthroplasty (THA). This study aimed to compare the outcomes of mesh reconstruction versus conventional capsular repair in maintaining capsular integrity and preventing dislocation after THA. Methods: This was a prospective, randomized controlled study of consecutive patients. 124 high-dislocation-risk THAs were identified and randomized into two groups, one using mesh reconstruction and the other using conventional capsular repair method. Perioperative data and radiological data were collected. Patients were followed up regularly. The main indexes were the capsular integrity assessed by magnetic resonance imaging (MRI) and hip dislocation rate. The secondary indexes included Harris hip score (HHS), complications, satisfaction. Results: 106 patients completed the follow-up and the average follow-up time was 19±3.1 and 18±3.3 months. The operation time of mesh group was longer than conventional group (P < 0.001). There were minor differences in acetabularanteversion and abduction angle, and the other data had no differences. MRI results showed the successful rate of capsular repair was higher in mesh group (50 hip, 98%) than in conventional group (37 hips, 67%) (P < 0.001) and the others failed the repair. Three dislocations occurred in conventional group while none in the mesh group. The preoperative HHS (30 points) and postoperative HHS (82 points) of mesh group were similar to those (35 points, 83points) of the conventional group (P = 0.164, P = 0.328). The satisfaction showed no difference (P=0.532). Conclusions: Compared to conventional repair, mesh reconstruction can effectively maintain the capsular integrity and decrease dislocation risk after THA without increasing the complications. Level of Evidence: Therapeutic study, Level IA

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“…Regardless of the approach, these complications can be prevented through preoperative and intraoperative measures. According to a Spanish cohort study, the capsular repair and transosseous reattachment of the external rotators can excellently decrease the peril of dislocation in patients undergoing THA in the posterior approach [14]. Also, a French multicentre case-control study found that an unrepaired joint capsule is considered a significant risk factor for dislocation in patients undergoing THA in any approach.…”

Section: Discussionmentioning

confidence: 99%

A Complication-Based Comparison Between the Posterior and Direct Lateral Approaches to Total Hip Arthroplasty: A Single-Center Experience

Aljuhani¹,

Alshuwaier²,

Alkhamis³

et al. 2021

Cureus

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Early dislocation in primary total hip arthroplasty using a posterior approach with repair of capsule and external rotators

Cited by 3 publications

References 26 publications

Using mesh in capsule anatomical reconstruction to enhance the stability of high-dislocation-risk hip arthroplasty: a randomized controlled trial

Using mesh in capsule anatomical reconstruction to enhance the stability of high-dislocation-risk hip arthroplasty: a randomized controlled trial

Using mesh in capsule anatomical reconstruction to enhance the stability of high- dislocation-risk hip arthroplasty: a randomized controlled trial

A Complication-Based Comparison Between the Posterior and Direct Lateral Approaches to Total Hip Arthroplasty: A Single-Center Experience

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