Modular Component Exchange for Treatment of Recurrent Dislocation of a Total Hip Replacement in Selected Patients

Toomey, Sean D.; Hopper, Robert H.; McAuley, James P.; Engh, Charles A.

doi:10.2106/00004623-200110000-00011

Cited by 78 publications

(26 citation statements)

References 10 publications

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“…At the time of revision, the surgeon may take advantage of numerous modular options, including increasing femoral head size, increasing neck length, or various liner options. Several studies have demonstrated reasonable success (69%-96%) with modular component exchange [61][62][63][64][65] .…”

Section: Modular Component Exchangementioning

confidence: 99%

Instability after total hip arthroplasty

Werner

Brown

2012

WJO

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Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter.

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Section: Modular Component Exchangementioning

confidence: 99%

Instability after total hip arthroplasty

Werner

Brown

2012

WJO

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“…They found BMI was the only risk factor in their patient population. Several studies have been performed in the population of patients requiring revision for recurrent dislocation [2,3,19,22]. Carter et al [3] found previous revision surgery and smaller head sizes put these patients at risk.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Dislocation After Revision Total Hip Arthroplasty

Wetters

Murray

Moric

et al. 2013

Clinical Orthopaedics &Amp; Related Research

184

112

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Background Despite dislocation being the most frequent complication after revision THA, risk factors for its occurrence are not completely understood. Questions/purposesWe therefore (1) determined the overall risk of dislocation after revision THA in a large series of revision THAs using contemporary revision techniques, (2) identified patient-related risk factors predicting dislocation, and (3) identified surgical variables predicting dislocation. Methods We performed 1211 revision THAs between June 2004 and October 2010 in 576 women and 415 men who had a mean age of 64.7 years (range, 25-95 years) at time of surgery. Forty-six (4%) were lost to followup and 13 died (1%), leaving 1152 hips followed for a minimum of 90 days (mean, 2 years; range, 90 days to 7.1 years). Multivariate logistic regression was performed to identify risk factors for dislocation. The model was also tested on patients followed for a minimum 1 year to assess any difference in longer followup. Results One hundred thirteen patients dislocated over the followup period (9.8%). Factors that were different between patients who dislocated and those who remained stable included a history of at least one previous dislocation (odds ratio [OR] = 2.673), abductor deficiency (OR = 2.672), and Paprosky acetabulum class (OR = 1.522).

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“…Revision strategies typically are directed by the identified causes for instability [9,19] and numerous methods have been described, including reorientation of the implants [17], the use of modular implants [21,42,55], elevated rim liners or socket wall addition [10,13,14,41,43,46,57], trochanteric advancement [22,32], removal of sources of impingement [17], and abductor repair [58]. However, even when the etiology could be clearly identified, limited success rates for stability ranging from 60% to 80% have been reported [2,3,17,22,37,44,45,49,53,55,59].…”

Section: Introductionmentioning

confidence: 99%

“…However, even when the etiology could be clearly identified, limited success rates for stability ranging from 60% to 80% have been reported [2,3,17,22,37,44,45,49,53,55,59].…”

Section: Introductionmentioning

confidence: 99%

Use of a Dual Mobility Socket to Manage Total Hip Arthroplasty Instability

Guyen

Pibarot

Vaz

et al. 2009

Clinical Orthopaedics &Amp; Related Research

178

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Unconstrained tripolar hip implants provide an additional bearing using a mobile polyethylene component between the prosthetic head and the outer metal shell. Such a design increases the effective head diameter and therefore is an attractive option in challenging situations of unstable total hip arthroplasties. We report our experience with 54 patients treated using this dual mobility implant in such situations. We ascertained its ability to restore and maintain stability, and examined component loosening and component failure. At a minimum followup of 2.2 years (mean, 4 years; range, 2.2-6

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Modular Component Exchange for Treatment of Recurrent Dislocation of a Total Hip Replacement in Selected Patients

Cited by 78 publications

References 10 publications

Instability after total hip arthroplasty

Instability after total hip arthroplasty

Risk Factors for Dislocation After Revision Total Hip Arthroplasty

Use of a Dual Mobility Socket to Manage Total Hip Arthroplasty Instability

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