Surgical management of recurrent dislocation after total hip arthroplasty

Charissoux, J.-L.; Asloum, Y.; Marcheix, Pierre-Sylvain

doi:10.1016/j.otsr.2013.11.008

Cited by 54 publications

(49 citation statements)

References 44 publications

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“…Thus, if component positioning is determined to be acceptable and the hip joint continues to be unstable, then trochanteric advancement may be a suitable choice [29]. For recurrent dislocation of hips, trochanteric advancement offers a surgical option for hip stability by re-tensioning the abductor muscles and increasing the lever arm [30]. In this study, the dislocation rate was lower than in other reports, and only one patient reported dislocation, which can be repaired by altering the position of the components or su cient repair of the short external rotators and securing greater trochanteric reattachment.…”

Section: Discussionmentioning

confidence: 99%

Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

Jin

Kim

et al. 2020

Preprint

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Background Failed treatment of subtrochanteric fractures commonly leads to pain, limping, and poor function. Cementless total hip arthroplasty (THA) could be an option as a salvage procedure in such cases. This study was to evaluate the clinical and radiological results and complications of this treatment in our hospital. Method Eighteen cementless THAs for failed treatment of subtrochanteric fractures were performed at our institution between January 2001 to December 2017. There were eleven males and seven females, and the average age was 74 years (range 57.0-89.0). Eight patients were previously operated with an intramedullary nail, six patients were treated with a dynamic hip screw, two patients were treated with an angled blade plate, one patient was treated with a proximal femur locking plate, and one patient was treated with a dynamic compression plate. Results The mean follow-up was 5.2 years (range 2.2-10.8). The mean duration of the operation was 98.0 minutes (standard deviation [SD],15.4; range 70-135). The mean total blood loss was 992.2 mL (SD,171.2; range 640-1260 mL), and the amount of transfusion was 2.2 units (SD, 0.8, range 1-4). The mean Harris hip score (HHS) was 38.2 (SD, 9.3; range, 24-56) preoperatively and 85.4 (SD, 4.9; range, 79-92) at the last follow-up. Compared to the patients treated with plate-screws, those treated with an intramedullary nail had significantly shorter surgical duration, fewer blood transfusions, and less intraoperative blood loss. Kaplan-Meier survivorship with an endpoint of revision was 94.4% (95% confidence interval 72.7-99.9) at five years. Conclusion Cementless THA is one of the acceptable procedures for failed treatment of the subtrochanteric fracture with fewer complications.

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Section: Discussionmentioning

confidence: 99%

Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

Jin

Kim

et al. 2020

Preprint

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“…There is no universally agreed stratagem 5 ; many authors propose identifying and addressing aetiological factors. 10,11 Multiple aetiologies often co-exist and successfully identifying and addressing these can be extremely challenging. Established treatment approaches including constrained liners have yielded relatively high rates of re-dislocation and failure.…”

Section: Discussionmentioning

confidence: 99%

Outcomes for cemented dual mobility cup to treat recurrent instability; A UK case series

Wheelton

Myatt

Helm

2019

Journal of Orthopaedics

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Recurrent dislocation of Total Hip Replacement (THR) is often multifactorial and remains a significant surgical challenge with a significant risk of further instability. Dual Mobility Cups (DMC) have been used widely with good long term results in France with few studies in the British literature, especially assessing their use for recurrent instability. We set out to assess whether recurrent instability can be successfully treated solely with revision of acetabular component to a dual mobility cup. Methods: We retrospectively reviewed a prospectively collected electronic database for all consecutive dual mobility cups implanted to address recurrently instability in THR. Radiological and clinical data have been analysed. Results: From September 2013 to September 2017 54 dual mobility cups have been implanted, mean age 78 (range 49-97). 47 were 1st time revision procedures, 7 were following previous revisions including 5 failed PLADs. Average time post primary was 10 years (range 8 months-23 years). Twenty cases are cement in cement revisions which has become our primary technique for revision of cemented cups. Mean follow up is 1.9 years (range 6 months-5 years), 37 cases have 2 year follow up available. 8 patients have died. There have been no episodes of further instability. One patient has had reoperation for infection (1st stage revision). Conclusions: This series demonstrates satisfactory early to mid-term results for the use of dual mobility cups to treat recurrent instability. The technique is particularly useful when femoral components are well fixed and can be used with monoblock implants such as the Charnley stem. Cement in cement revision is a convenient technique and potentially reduces complications and cost. Further analysis of longer term data is required but these results suggests this could be a valid solution to a complex problem.

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“…In our study, we did not find any luxation or bone fracture near the implant, but this might be attributable to the character of the study group. Many authors have emphasized that the elevated risk of these complications occurs in female patients aged over 80 years and after previous surgical interventions in the hip joint ( Berry et al, 2004 ; Charissoux et al, 2014 ; Jolles et al, 2002 ; Lindahl et al, 2007 ; Meek et al, 2008 ), and such patients were not qualified for the study.…”

Section: Discussionmentioning

confidence: 99%

Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty

Czech

Hermanson

Rodak³

et al. 2017

Journal of Human Kinetics

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An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients’ willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.

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Surgical management of recurrent dislocation after total hip arthroplasty

Cited by 54 publications

References 44 publications

Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

Outcomes for cemented dual mobility cup to treat recurrent instability; A UK case series

Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty

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