Ultimate Outcome in Immediate Postoperative Total Hip Arthroplasty Instability

Mahoney, Craig R.; Heitenberger, Sven; Sanchez, Pamela; Schaefer, Sarah; Sculco, Thomas P.; Westrich, Geoffrey H.

doi:10.1016/j.arth.2006.02.168

Cited by 15 publications

(9 citation statements)

References 5 publications

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“…The reasons for which a primary THR may dislocate have been classified into factors related to the patient, surgeon, surgical technique, implant design and the soft tissue. 4,5 Recurrent dislocation, defined as two or more episodes of dislocation, occurs in between 10.3% 6 and 60% 7 of patients after a first dislocation. The risk factors that predispose to recurrent dislocation include previous surgery, late dislocation, component malposition, imbalance of tissue tension, the surgical approach, the design of the prosthesis, the experience of the surgeon, the pathological diagnosis, a small femoral head, component malposition, failure of the abductor mechanism and a long femoral neck.…”

mentioning

confidence: 99%

Outcome of treatment for dislocation after primary total hip replacement

Kotwal

Ganapathi

John

et al. 2009

The Journal of Bone and Joint Surgery. British volume

107

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We have studied the natural history of a first episode of dislocation after primary total hip replacement (THR) to clarify the incidence of recurrent dislocation, the need for subsequent revision and the quality of life of these patients. Over a six-year period, 99 patients (101 hips) presented with a first dislocation of a primary THR. A total of 61 hips (60.4%) had dislocated more than once. After a minimum follow-up of one year, seven patients had died. Of the remaining 94 hips (92 patients), 47 underwent a revision for instability and one awaits operation (51% in total). Of these, seven re-dislocated and four needed further surgery. The quality of life of the patients was studied using the Oxford Hip Score and the EuroQol-5 Dimension (EQ-5D) questionnaire. A control group of patients who had not dislocated was also studied. At a mean follow-up of 4.5 years (1 to 20), the mean Oxford Hip Score was 26.7 (15 to 47) after one episode of dislocation, 27.2 (12 to 45) after recurrent dislocation, 34.5 (12 to 54) after successful revision surgery, 42 (29 to 55) after failed revision surgery and 17.4 (12 to 32) in the control group. The EuroQol-5 dimension questionnaire revealed more health problems in patients undergoing revision surgery.

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mentioning

confidence: 99%

Outcome of treatment for dislocation after primary total hip replacement

Kotwal

Ganapathi

John

et al. 2009

The Journal of Bone and Joint Surgery. British volume

107

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“…Physical therapy after discharge lacks evidence in case of a single THA [21], but not if a patient underwent MJP. The most common complication (2–5%) is subluxation [22], which did not occur once in our group, probably because of the moderate pace during the rehabilitation process. This is most satisfying because once a subluxation does occur, the change for re‐subluxation goes up to 33% [22], as well as the change for (re)bleeds will change the functional perspective for individuals of this group dramatically.…”

Section: Discussionmentioning

confidence: 72%

In-hospital rehabilitation after multiple joint procedures of the lower extremities in haemophilia patients: clinical guidelines for physical therapists

Kleijn

Fischer

Vogely³

et al. 2011

Haemophilia

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This project aimed to develop guidelines for use during in-hospital rehabilitation after combinations of multiple joint procedures (MJP) of the lower extremities in persons with haemophilia (PWH). MJP are defined as surgical procedures on the ankles, knees and hips, performed in any combination, staged, or during a single session. MJP that we studied included total knee arthroplasty, total hip arthroplasty and ankle arthrodesis. Literature on rheumatoid arthritis demonstrated promising functional results, fewer hospitalization days and days lost from work. However, the complication rate is higher and rehabilitation needs optimal conditions. Since 1995, at the Van Creveldkliniek, 54 PWH have undergone MJP. During the rehabilitation in our hospital performed by experienced physical therapists, regular guidelines seemed useless. Guidelines will guarantee an optimal physical recovery and maximum benefit from this enormous investment. This will lead to an optimal functional capability and optimal quality of life for this elderly group of PWH. There are no existing guidelines for MJP, in haemophilia, revealed through a review of the literature. Therefore, a working group was formed to develop and implement such guidelines and the procedure is explained. The total group of PWH who underwent MJP is described, subdivided into combinations of joints. For these subgroups, the number of days in hospital, complications and profile at discharge, as well as a guideline on the clinical rehabilitation, are given. It contains a general part and a part for each specific subgroup.

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“…No patients were revised. 2 Li et al demonstrated poorer prognosis at longer follow-up, with 62.5% of patients experiencing recurrent dislocation, and 50% of patients being revised for instability at a minimum of 7 years postoperatively. 3 Forsythe et al found that Reduced WOMAC and Short Form-12 (SF-12) scores were similar between patients with a single dislocation and patients who had no dislocations at a mean of 1.8 years postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…1 The current literature contains abundant information regarding the prognosis, risk of recurrent instability, and revision rates following a posterior dislocation. [2][3][4][5][6] However, anterior hip dislocation has been shown to be a relatively infrequent event and there are little data on outcomes of patients with these types of dislocation. [7][8][9] The purpose of the current study was to assess the functional outcomes and survival of the prosthetic hip in patients who have sustained an anterior dislocation and to compare these results with a similar cohort of patients who have sustained a posterior dislocation.…”

mentioning

confidence: 99%

The Natural History of the Anteriorly Dislocated Total Hip Arthroplasty

et al. 2019

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Dislocation with instability is one of the most frequent causes of early failure and subsequent revision following primary total hip arthroplasty. However, anterior hip dislocation has been shown to be a relatively infrequent event and there are little data on outcomes of patients with these types of dislocation. The purpose of the current study was to assess the functional outcomes and survival of the prosthetic hip in patients who have sustained an anterior dislocation and to compare these results with a similar cohort of patients who have sustained a posterior dislocation. The charts and radiographs of patients sustaining an anterior dislocation following primary total hip arthroplasty were reviewed at an average of 7 years after the index procedure. Redislocation rate, revision status, and function as assessed by the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) were examined. These were compared with an age- and gender-matched cohort of patients who had sustained a posterior dislocation. Patients sustaining an anterior dislocation were found to have a mean acetabular anteversion of 36 degrees, compared with 25.6 degrees in patients who had sustained a posterior dislocation. However, this did not result in any difference in revision rate or WOMAC score at the time of follow-up. The current evidence shows us that a single-posterior dislocation does not preclude a satisfactory long-term outcome. Based on their data, the authors feel it would be appropriate to counsel patients that a single-anterior dislocation also does not preclude a satisfactory outcome.

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Ultimate Outcome in Immediate Postoperative Total Hip Arthroplasty Instability

Cited by 15 publications

References 5 publications

Outcome of treatment for dislocation after primary total hip replacement

Outcome of treatment for dislocation after primary total hip replacement

In-hospital rehabilitation after multiple joint procedures of the lower extremities in haemophilia patients: clinical guidelines for physical therapists

The Natural History of the Anteriorly Dislocated Total Hip Arthroplasty

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