Surgical Experience Related to Dislocations After Total Hip Arthroplasty

Hedlundh, Urban; Ahnfelt, Lennart; Hybbinette, Carl-Henrik; Weckström, J; Fredin, Hans

doi:10.1302/0301-620x.78b2.0780206

Cited by 136 publications

(60 citation statements)

References 16 publications

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“…The rate of dislocation has an inverse relationship to the experience of the surgeon [55] . For every ten primary arthroplasties performed yearly, there is a 50% reduction in the postoperative dislocation rate [55] . There is also a high dislocation rate amongst surgeons who perform less than thirty THAs yearly [7] .…”

Section: Surgical Factorsmentioning

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: Surgical Factorsmentioning

confidence: 99%

Instability after total hip arthroplasty

Werner

Brown

2012

WJO

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“…There is evidence that trainee surgeons have poorer results and increased complications than consultant surgeons more familiar with the operative technique. This also may be the case with less experienced consultant surgeons [2,[5][6][7]11]. However, Mahaluxmivala measured the radiological positioning of 673 PFC total knee arthroplasties and found no significant differences between consultants and trainees, so the argument is not clear cut [13].…”

Section: Discussionmentioning

confidence: 99%

“…An inexperienced surgeon has double the dislocation rate in hip arthroplasty [6]. However, there are few published data on the outcome of knee arthroplasty undertaken by surgeons at the start of their practice [7,13].…”

Section: Introductionmentioning

confidence: 99%

Ten-year survival analysis of the PFC total knee arthroplasty-a surgeon’s first 99 replacements

Santini

Raut

2007

International Orthopaedics (SICO

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Ninety-seven patients with 99 total knee arthroplasties were operated on by a surgeon in the first 3 years of his surgical career. Complete survival data were available for all 99 knees. The cases were reviewed at a minimum of 10 years after their initial operation, but as 37 patients had died before reaching 10 years, the average follow-up was 8 years 8 months with a maximum of 12 years 4 months. Ninety-one patients had osteoarthritis, five had rheumatoid arthritis, and three had juvenile chronic arthritis. No patients were lost to follow-up. Four required revision. The 10-year survival rate, using revision for all causes as an end-point, was 94.96%. The survival rate for aseptic loosening was 97.04%. The survival rate for loose joints that had not been revised was 94.13%. Three of the four revisions occurred in the first 6 patients operated upon, suggesting there may be a learning curve for surgeons at this stage in their career.Résumé Quatre-vingt-dix-sept patients ayant bénéficié de 99 prothèses totales du genou mises en place par un seul chirurgien lors de ces trois premières années d'activité. Toutes les données ont été récoltées pour ces 99 genoux. Ces patients ont été revus avec un minimum de 10 ans après l'intervention. Trente-sept étaient décédés. Le suivi moyen était de 8 ans 8 mois avec un maximum de 12 ans 4 mois. Quarante-vingt-onze patients avaient été traités pour arthrose, 5 pour arthrite rhumatoïde et 3 pour arthrite rhumatoïde juvénile, maladie de Still-Chauffard. Aucun patient n'a été perdu de vue. Quatre ont nécessité une reprise chirurgicale. Le taux de révision à 10 ans en prenant comme contrôle la révision quelle que soit la cause a été de 94.96%, le taux de survie pour descellement aseptique de 97.04%. Le taux de survie pour les patients qui n'ont pas été repris a été de 94.13%. Trois des quatre révisions sont survenues chez les six premiers patients opérés par le chirurgien et faisaient partie de la courbe d'apprentissage.

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“…Postoperative dislocation remains a common major complication after total hip arthroplasty (THA) with an overall incidence of 2% to 3%, but approaching less than 1% after primary THA [1][2][3][4][5][6][7][8][9]. Khatod et al [10] reported dislocation rates of 1.7% for primary THA and 5.1% for revision procedures using contemporary techniques and implants with a community-based registry.…”

Section: Introductionmentioning

confidence: 99%

“…Patient factors include neuromuscular and cognitive disorders, patient non-compliance, and previous hip surgery [8,13,14]. Surgical considerations include the approach [9,15], soft tissue tension [5], component positioning [11,[16][17][18], impingement [19], femoral head size [3,20], acetabular liner profile [4], and surgeon experience [6]. The average time to the initial dislocation after a primary procedure is relatively short [3,8,9,21].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of an Abduction Brace in Preventing Initial Dislocation in the Early Postoperative Period after Primary Total Hip Arthroplasty

Ishii¹,

Noguchi²,

Takeda³

et al. 2012

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We hypothesized that a hip brace may prevent the initial dislocation in the early postoperative period after total hip arthroplasty (THA). We performed a prospective evaluation of the efficacy of a brace in preventing dislocation in 54 primary THAs in 43 patients. All of the patients wore braces for 3 weeks postoperatively. The occurrence of dislocation was evaluated six months postoperatively. There were no cases of dislocation while wearing a brace, while two posterior dislocations occurred 8 and 12 days postoperatively while picking something up from the floor without a brace in so-called provocative positions. The results of this study suggest that a hip brace helps patients to recognize careless provocative positions and prevents the initial hip dislocation in this period instead of usual postoperative management for an average of 6 weeks after discharge, such as a high toilet seat, restricted hip flexion in the activities of daily living, use of a reacher or grabber, an abduction pillow, and a high chair.

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Surgical Experience Related to Dislocations After Total Hip Arthroplasty

Cited by 136 publications

References 16 publications

Instability after total hip arthroplasty

Instability after total hip arthroplasty

Ten-year survival analysis of the PFC total knee arthroplasty-a surgeon’s first 99 replacements

Efficacy of an Abduction Brace in Preventing Initial Dislocation in the Early Postoperative Period after Primary Total Hip Arthroplasty

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