The Unstable Total Hip Replacement

Padgett, Douglas E.; Warashina, Hideki

doi:10.1097/00003086-200403000-00011

Cited by 125 publications

(99 citation statements)

References 34 publications

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“…ing surgery [1,8,9,[17][18][19] . Accordingly, the cumulative risk of dislocation does not remain constant following THA, increasing with time due to trauma, polyethylene wear, increased pseudocapsule laxity and deteriorating muscle strength [20][21][22] .…”

Section: Topic Highlightmentioning

confidence: 99%

“…A history of prior hip surgery is also considered to be an independent risk factor for dislocation [14,17,36,38,40] . Woo and Morrey found the incidence of instability to double in hips that had undergone any previous open surgical procedure [1] .…”

Section: Patient Factorsmentioning

confidence: 99%

“…The risk of dislocation is influenced by patient factors such as age, sex, previous surgery, and cognitive or neurologic disorders as well as surgical factors, including surgical approach, choice of implant, soft tissue and surgeon experience [13][14][15] . Although most dislocations after THA are isolated events and can be managed nonoperatively, some patients will require surgical intervention to manage or prevent recurrent instability [7,16,17] . A thorough understanding of the etiology of dislocations, evaluation of an unstable THA, and appropriate management of such instability is necessary to ensure optimum outcomes for patients.…”

Section: Introductionmentioning

confidence: 99%

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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: Topic Highlightmentioning

confidence: 99%

Section: Patient Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Instability after total hip arthroplasty

Werner

Brown

2012

WJO

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“…Second, the minimum followup was 2 years and because the cumulative risk increases with time, longer followup would increase the rate of dislocation. However, more than of all dislocations reportedly occur within the first year postoperatively [10], and most of these occur within the first 6 weeks [9,13]. Thus, we do not anticipate the overall dislocation rate would be substantially different.…”

Section: Discussionmentioning

confidence: 88%

Do Joint Registries Report True Rates of Hip Dislocation?

Devane

Wraighte

Ong

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Despite advances in primary THA, dislocation remains a common complication. In New Zealand (NZ), dislocations are reported to the National Joint Registry (NJR) only when prosthetic components are revised in the treatment of a dislocation. Closed reductions of dislocated hips are not recorded by the NJR. Questions/purposes We compared the true dislocation rate for patients receiving primary THA in the Wellington region with the rate reported by the NZ NJR for the same group of patients. Methods The NZ NJR identified 570 patients undergoing primary THA from

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“…There are many risk factors for post operative hip instability that are not related to the surgeon. This complication occurs more often in elderly patients, patients with neurological disorders or mental health problems, alcohol abuse, and a history of hip joint surgery [2][3][4][5]. Postoperative hip instability is twice as common in women as in men.…”

Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty Using Cementless Avantage Cup in Patients with Risk of Hip Prosthesis Instability

Semenowicz¹,

Mroczka²,

Kajzer

et al. 2014

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Ce lem pra cy by ła oce na alo pla sty ki sta wu bio dro we go z wy ko rzy sta niem bez ce men to wej pa new ki Avan ta ge u ko biet z do dat ko wy mi czyn ni ka mi ry zy ka po ope ra cyj nej nie sta bil no ści.Ma te riał i me to dy. W la tach 2004-2010 im plan to wa no 280 bez ce men to wych pa ne wek sys te mu Avan ta ge i Avan ta ge Re lo ad u 260 ko biet w wie ku od 29 do 79 (śred nia 60) 9 lat. U 217 ko biet wy stę po wał przy naj mniej 1 do dat ko wy czyn nik ry zy ka zwich nię cia en do pro te zy. Prze ży wal ność pa new ki oce nia no okre śla jąc ja ko punkt koń co wy ko niecz ność jej wy miany. W ana li zach sta ty stycz nych wy ko rzy sta no do kład ny test Fi she ra ce lem oce ny ró żni cy w ko niecz no ści re wi zji mię dzy pa new ką Avan ta ge a Avan ta ge Re lo ad, krzy wą Ka pla na-Me ie ra w sza co wa niu cza su spraw ne go dzia ła nia en do pro te zy. Prze pro wa dzo no rów nież ba da nia war stwy po wierzch nio wej 2 nie uży tych oraz 4 usu nię tych pa ne wek.Wy ni ki. Koń co we mu ba da niu pod da no 239 cho rych (259 alo pla styk). Okres ob ser wa cji wy no sił od 2, 7 do 9, 6 lat, śred nio 7, 0 lat. U żad nej cho rej nie ob ser wo wa no po ope ra cyj nej nie sta bil no ści en do pro te zy sta wu bio dro we go. Asep tyczne mu ob lu zo wa niu ule gło 19 pa ne wek u 18 ko biet (7, 3%). We wnątrzpro te zo we zwich nię cie wy stą pi ło czte ro krot nie, w dwóch przy pad kach łącz nie z ob lu zo wa niem pa new ki. Re wi zja czę ściej wy ma ga na by ła w przy pad ku pa new ki Avan tage (9, 5%; 17 spo śród 179) w po rów na niu z pa new ką Avan ta ge Re lo ad (2, 5%; 2 spo śród 80), jed nak ob ser wo wa ne ró żni -ce nie osią gnę ły po zio mu sta ty stycz nej zna mien no ści. Praw do po do bień stwo prze ży cia pa new ki Avan ta ge wy no si ło po 5 la tach: 0, 94 oraz po 8 la tach: 0, 86.Wnio ski. 1. Za sto so wa nie pa new ki Avan ta ge zmniej sza ry zy ko po ope ra cyj nej nie sta bil no ści sta wu. 2. Pa cjen ci, u któ rych za sto so wa no bez ce men to wą pa new kę Avan ta ge po win ni być ści śle ob ser wo wa ni pod ką tem jej asep tycz ne go ob lu zo wa nia.Słowa kluczowe: staw biodrowy, endoprotezoplastyka, panewka z podwójnym ruchem, zwichnięcie, czynniki ryzyka, powikłania SUMMARY Background. The aim of the study was to assess total hip arthroplasty procedures using the cementless Avantage cup in women with additional risk factors for postoperative hip instability.Material and methods. A total of 280 cementless Avantage and Avantage Reload cups were implanted in 260 women aged between 29 and 79 years (60.9 years on average) in the years 2004-2010. In 217 women, there was at least one additional risk factor for prosthesis dislocation. The survival of the cup was assessed by using the necessity of cup replacement as an endpoint of the study. The statistical analyses used the Fisher test to assess the difference in the necessity of revision surgery between the Avantage and Avantage Reload cups, and the Kaplan Meier method was used to evaluate the effective functioning time of...

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The Unstable Total Hip Replacement

Cited by 125 publications

References 34 publications

Instability after total hip arthroplasty

Instability after total hip arthroplasty

Do Joint Registries Report True Rates of Hip Dislocation?

Total Hip Arthroplasty Using Cementless Avantage Cup in Patients with Risk of Hip Prosthesis Instability

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