Incidence Rates of Dislocation, Pulmonary Embolism, and Deep Infection During the First Six Months After Elective Total Hip Replacement

Phillips, C I; Barrett, Jane; Losina, Elena; Mahomed, Nizar N.; Lingard, Elizabeth A.; Guadagnoli, Edward; Baron, John A.; Harris, William H.; Poss, Robert; Katz, Jeffrey N.

doi:10.2106/00004623-200301000-00004

Cited by 440 publications

(218 citation statements)

References 15 publications

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“…The rates of GT fractures (3%), persistent trochanteric pain (5%), and new onset abductor lurch (5%) were low, not different from the complication rates in the control group, and not associated with fibrous union or nonunion. The postoperative dislocation rate was 5%, comparable to the rates of dislocations after primary THAs and much lower than the typical rates for revisions [13].…”

Section: Discussionmentioning

confidence: 49%

Trochanteric Slide Osteotomy on Previously Osteotomized Greater Trochanters

Lakstein¹,

Kosashvili²,

Backstein³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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The sliding trochanteric osteotomy is a useful and safe technique facilitating exposure of the hip in a complex arthroplasty. The modified sliding trochanteric osteotomy preserves the posterior capsule and short external rotators, allows anterior dislocation of the hip, and is associated with a lower dislocation rate. With the increased incidence of failed THAs and need for revision, there is an increased need for better exposure of challenging hips. Therefore, trochanteric osteotomies in hips that previously had osteotomies are not uncommon and likely will become frequent in the future. We evaluated use of the modified trochanteric slide osteotomy on greater trochanters that previously had osteotomies and were healed. We reviewed 38 patients with repeated osteotomies and 38 matched control patients with osteotomies on greater trochanters that did not have previous osteotomies. The minimum followup was 13 months (mean, 37 months; range, 13-73 months). Thirty-three osteotomies (87%) healed with bony union, four (11%) had fibrous union, and one (3%) had nonunion. Two (5%) patients had a new onset abductor lurch develop. Two (5%) patients had persistent trochanteric pain and two (5%) had dislocations. The bony union, fibrous union, and nonunion rates, and the abductor lurch, persistent trochanteric pain, and dislocation rates, were similar to those of the control patients. Repeated osteotomy on a previously healed greater trochanter osteotomy is a reliable procedure with similar clinical outcome and complication rates as a primary osteotomy.

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Section: Discussionmentioning

confidence: 49%

Trochanteric Slide Osteotomy on Previously Osteotomized Greater Trochanters

Lakstein¹,

Kosashvili²,

Backstein³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Dislocation after THA remains a prominent concern, because its frequency is reported to range from 1% to 5% [4,25]. With the increasing utilization rates of THAs [28], there is also an expected subsequent rise in the number of dislocations.…”

Section: Introductionmentioning

confidence: 99%

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Chughtai

Diedrich

Jauregui

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting. Questions/purposes (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes? (4) What are the complications of dual-mobility articulations in primary THA? Methods Between 2011 and 2013, the five participating surgeons performed 495 cementless primary THAs. During that time, one of the five surgeons used dual-mobility articulations for all THAs, and the other four used it whenever the acetabular cup size was 52 mm or greater to enable a 28-mm head. Of the 495 patients, 453 (92%) were performed using this device. Smaller patients were treated with a standard THA. Of the 453 patients, a total of 43 One of the authors certifies that he (PMB) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics (Mahwah, NJ, USA) and an amount of USD 10,000 to USD 100,000 from Joint Active Systems (Effingham, IL, USA). One of the authors certifies that he (SFH) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics, less than USD 10,000 from Slack Inc (Thorofare, NJ, USA), an amount of USD 10,000 to USD 100,000 from Convatec, and less than USD 10,000 from Thieme Inc (New York, NY, USA). One of the authors certifies that he (ALM) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics. One of the authors certifies that he (FRK) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics and an amount of USD 10,000 to USD 100,000 from DJ Orthopedics (Vista, CA, USA). One of the authors certifies that he (MAM) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics, an amount of USD 10,000 to USD 100,000 from DJ Orthopedics, an amount of USD 10,000 to USD 100,000 from Microport (Arlington, TN, USA), an amount of USD 10,000 to USD 100,000 from J&J (New Brunswick NJ, USA), an amount of USD 10,000 to USD 100,000 from Medical Compression Systems (Tel Aviv, Israel), an amount of USD 10,000 to USD 100,000 from OnGoing Care Solutions (Pinellas Park, FL, USA), an amount of USD 10,000 to USD 100,000 from Sage Products LLC (Cary, IL, USA), an amount of USD 10,000 to USD 100,000 from TissueGene (Rockville, MD, USA) an amount of USD 10,000 to USD 100,000 from Pacira Pharmaceuticals (Parsippany, NJ, USA), an amount of USD 10,000 to USD 100,000 from Merz (Frankfurt, Germany), and an amount of USD 10,000 ...

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“…The decision model incorporates the need for subsequent hip revision surgery and the possible complications that can arise. The incidence of complications is assumed to increase with subsequent revision procedures, whereas the durability of revision arthroplasty is assumed to decrease relative to primary arthroplasty [24,26,27]. The probabilities of infection, dislocation, and mortality used in this model are shown in Table 1.…”

Section: Decision Modelmentioning

confidence: 99%

Cost-effectiveness Analysis of Core Decompression

SooHoo

Vyas

Manunga

et al. 2006

The Journal of Arthroplasty

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Core decompression is widely used to treat the early stages of osteonecrosis of the hip. The purpose of this analysis is to assist orthopedic surgeons in judging whether currently available data support the use of core decompression as cost-effective. A decision model was created for the treatment of osteonecrosis of the femoral head. Literature review was used to identify possible outcomes and their probability after initial treatment with either observation or core decompression. This model demonstrates core decompression must delay the need for total hip arthroplasty for a minimum of 5 years to maintain an incremental cost-effectiveness ratio lower than $50 000 per quality-adjusted life year gained. Treatment options with ratios higher than $50 000 per quality-adjusted life year are generally considered to have limited cost-effectiveness. This study demonstrates that core decompression has the potential to be a highly cost-effective alternative if it is leads to a delay in the need for total hip arthroplasty of 5 years or longer.

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Incidence Rates of Dislocation, Pulmonary Embolism, and Deep Infection During the First Six Months After Elective Total Hip Replacement

Cited by 440 publications

References 15 publications

Trochanteric Slide Osteotomy on Previously Osteotomized Greater Trochanters

Trochanteric Slide Osteotomy on Previously Osteotomized Greater Trochanters

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Cost-effectiveness Analysis of Core Decompression

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