Results of Total Hip Arthroplasty Differ in Subtypes of High Dislocation

Hartofilakidis, George; Babis, George C.; Lampropoulou-Adamidou, Kalliopi; Vlamis, John

doi:10.1007/s11999-013-2983-x

Cited by 21 publications

(18 citation statements)

References 12 publications

(16 reference statements)

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“…This is in accordance with the findings of Hartofilakidis et al . ; although they did not pay attention to the difference in the dislocation rates between different types of high dislocation. In Hartofilakidis' study, three dislocations occurred out of 30 hips in the no false acetabulum group (10%) while there were zero out of 49 hips in the false acetabulum group (0%).…”

Section: Discussionmentioning

confidence: 92%

“…; although they did not pay attention to the difference in the dislocation rates between different types of high dislocation. In Hartofilakidis' study, three dislocations occurred out of 30 hips in the no false acetabulum group (10%) while there were zero out of 49 hips in the false acetabulum group (0%). This can be explained by the fact hips without false acetabulum have a worse soft tissue condition and abductor muscle strength because of a high‐riding femoral head in the gluteal musculature, and it has a more abnormal proximal femur shape caused by the lower mechanical loads.…”

Section: Discussionmentioning

confidence: 95%

“…Measurements were made on preoperative and immediate postoperative AP pelvic radiographs. High dislocation in hips with or without a false acetabulum were distinguished according to Hartofilakidis. The subluxation height was the distance from the head–neck junction to the interteardrop line.…”

Section: Methodsmentioning

confidence: 99%

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Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip

Ding

Zeng

Mou

et al. 2020

Orthopaedic Surgery

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Objective: To investigate whether the risk of dislocation after total hip arthroplasty (THA) in patients with Crowe type IV developmental dysplasia of the hip (DDH) is high and to further identify the risk factors for postoperative dislocation in these patients.Methods: This retrospective cohort study reviewed Crowe type IV DDH patients undergoing THA between January 2009 and December 2017 in our institution. Each Crowe type IV DDH patient was matched with three Crowe type I, II, or III DDH patients according to gender, side and date of operation. The primary outcome of this study was postoperative dislocation after THA. Occurrence, rate, classification, treatment and outcome of dislocation were documented in detail for all patients. The dislocation rates were compared between Crowe type IV DDH patients and Crowe type I, II, or III DDH patients. Demographic data, implant factors, and surgical factors were compared between the dislocation and no dislocation groups. Multiple logistic regression analysis was used to determine the independent risk factors for dislocation in Crowe type IV hips.Results: A total of 131 Crowe type IV hips were followed up for a mean of 76.5 AE 28.1 months. Three hundred and ninety-three Crowe type I, II and III hips, including 261 type I hips, 94 type II hips, and 38 type III hips, were identified as controls and followed up for a mean of 76.4 AE 28.2 months. No significant difference was observed in follow-up time between two groups (P = 0.804). One or more dislocations occurred in 22 of the 524 dysplasia hips (4.20%). Of the 22 dislocated hips, 20 hips (90.9%) were successfully managed with non-operative treatment. Two patients (9.1%, one Crowe type I and one Crowe type IV) experienced recurrent dislocation and required revision surgery. Crowe type IV hips had a significantly higher postoperative dislocation rate than type I, II, and III hips (11.45% vs 1.78%, P < 0.001). The use of a 22-mm femoral head (odds ratio [OR] = 23.55, 95% confidence interval [CI] = 1.901-291.788, P = 0.014), older age (OR = 1.128, 95% CI = 1.037-1.275, P = 0.031), and absence of false acetabulum (OR = 12.425, 95% CI = 1.982-77.879, P = 0.007) were identified as independent risk factors for dislocation in Crowe type IV hips.Conclusions: Crowe type IV DDH patients were at a high risk of dislocation after THA, and using large femoral heads and improving abductor muscle strength may help decrease the rate of postoperative dislocation in such patients.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 95%

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Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip

Ding

Zeng

Mou

et al. 2020

Orthopaedic Surgery

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“…In most cases, the rotation center can only be corrected by femoral shortening osteotomy. 1 , 2 , 3 , 4 , 5 Even after osteotomy, the necessary stretching to reconstruct the hip in the paleoacetabulum may cause neurovascular injuries, most of which are sciatic neurapraxia. In the present study, the authors used transverse osteotomies at the subtrochanteric and also at the supracondylar level.…”

Section: Discussionmentioning

confidence: 99%

“…Typically, patients present after decades of evolution and adaptation to the abnormal hip position in the neoacetabulum or false acetabulum, with disabling complaints of pain and functional limitation due to the development of early secondary coxarthrosis (whose symptoms are typically observed in the fourth and fifth decades of life). 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 Arthroplasty reconstruction at the correct center of rotation of the hip, at the level of the true acetabulum or paleoacetabulum, has been shown to have superior biomechanical results (among which, the increase in the lever arm and in the strength of the abductor muscles), and superior arthroplasty duration when compared with the more cephalic application of the arthroplasty. 6 , 10 , 11 , 12 , 13 , 14 , 15 In order to bring the femur into the paleoacetabulum and prevent or minimize the occurrence of neurovascular injuries due to excessive stretching, a femoral shortening osteotomy is usually required in high dislocations.…”

Section: Introductionmentioning

confidence: 99%

High congenital hip dislocation in adults – arthroplasty and functional results

Moura

Figueiredo

2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveRetrospective case–control study on the authors’ experience regarding arthroplasty in high congenital dislocations of the hip in adults.MethodsSample with 11 high congenital hip dislocations (Hartofilakidis type C) that occurred in seven patients, who were submitted to hip arthroplasty by the same surgeon and with the same surgical technique. Mean follow-up period was 4.32 ± 2.67 years (minimum one year) and all patients were evaluated by the same examiner.ResultsAll the arthroplasties had cementless fixation, with application of screwed acetabular cups, conical femoral stems, and a metal-polyethylene articular pars. In every patient, shortening femoral osteotomies were performed at subtrochanteric or supracondylar locations. The mean Harris Hip Score at the last evaluation was 88.55 ± 4.50 (range 81–94). The mean time with high dislocation of the hip (42.91 ± 14.59 years, range 19–68) showed a significant inverse correlation with Harris Hip Score (r = 0.80; p = 0.003). All patients reported important relief of pain complaints and are capable of ambulation without any external support. In the unilateral dislocations, leg length discrepancies were fully corrected; in the bilateral cases, isometric limbs were achieved in all patients. All osteotomies consolidated, with a mean interval of 3.27 ± 0.47 months. There were complications in 18.18% of the sample: one iatrogenic intraoperative fracture of the greater trochanter and a transitory sciatic neurapraxia.ConclusionDespite being a demanding surgery with a reportedly high complication rate, total hip arthroplasty in high congenital dislocations, when properly indicated and technically correctly performed, allows an improvement in function and quality of life.

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Preexisting Conditions Leading to Total Hip Arthroplasty

Tokgoz

2022

Total Hip Arthroplasty

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Results of Total Hip Arthroplasty Differ in Subtypes of High Dislocation

Cited by 21 publications

References 12 publications

Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip

Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip

High congenital hip dislocation in adults – arthroplasty and functional results

Preexisting Conditions Leading to Total Hip Arthroplasty

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