Factors predisposing to dislocation of the Thompson hemiarthroplasty: 22 dislocations in 338 patients

What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

“…The posterior surgical approach clearly increases the risk of dislocation, as supported by several clinical studies on patients with hip fracture [6,19,20]. Enocson et al [6] reported a higher dislocation proportion of 13% using the posterolateral approach than the 3% with the anterolateral approach in 720 patients with femoral neck fractures, and Pajarinen et al [19] reported a 16% dislocation rate after surgery through the posterior approach compared with 7% after the anterior approach in 338 hip fracture surgeries. The proportion of dislocations in the 508 patients in our study after surgery through the anterolateral approach was 6%, which was less than the 11% dislocation rate reported after surgery through the posterior approach in another recent cohort study [17].…”

“…These are major complications of hip arthroplasty performed on patients with displaced femoral neck fractures [1,22]. The posterior surgical approach clearly increases the risk of dislocation, as supported by several clinical studies on patients with hip fracture [6,19,20]. Enocson et al [6] reported a higher dislocation proportion of 13% using the posterolateral approach than the 3% with the anterolateral approach in 720 patients with femoral neck fractures, and Pajarinen et al [19] reported a 16% dislocation rate after surgery through the posterior approach compared with 7% after the anterior approach in 338 hip fracture surgeries.…”

Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?

“…The factors contributing to dislocation in patients who had bipolar HAs are not well known. A history of hip surgery, inadequate soft tissue tension, method of surgical approach, and preoperative [1,6,20,25,32]; it is known that patients with neuromuscular diseases have a greater incidence of postoperative dislocations after THA [9,25,31]. Once the dislocation has occurred, complications and morbidity related to difficulty in manual reduction, chances of open reduction, and replacement of prostheses increase [2,12,22,25,27].…”

“…Some authors consider the posterior approach a risk factor for dislocation after bipolar HA [6,20,32]. Paton and Hirst [22] reported on Monk and Charnley-Hastings bipolar arthroplasties in 63 hips and found a dislocation rate of 4.8%.…”

CORR Insights®: What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

“…Dislocation rates of hemiarthroplasties range from 1.6% to 16% [2,10]. Clinical studies have reported higher dislocation rates with arthroplasties performed through a posterolateral approach [1,6].…”