Skip to main content

Advertisement

SpringerLink
Log in

Risk Factors for Dislocation following Total Hip Arthroplasty in Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis

  • Review
  • Published:
International Orthopaedics Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 20 October 2023

Abstract

Purpose

This systematic review and meta-analysis aimed to identify risk factors of dislocation after total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH).

Methods

A systematic literature review was performed on 18th August 2022 using Medline, Embase, Scopus, Web of Science electronic databases, and a manual search. The study was conducted according to the PRISMA guidelines and registered with PROSPERO. Statistical analysis includes assessment of heterogeneity and data synthesis using RevMan 5.4.

Results

Review of five studies including 2865 patients and 116 dislocated hips found that lower body mass index (BMI) (SMD = 0.22, p = 0.04, I2 = 0%), Crowe classification type IV versus I, II, and III (OR = 2.70, p = 0.004, I2 = 51%), higher cup inclination (SMD = 0.39 p = 0.0007, I2 = 0%), femoral head size < 28 mm (OR = 5.07, p = 0.003, I2 = 71%), lateral surgical approach (OR = 1.96, p = 0.02, I2 = 0%), and postoperative infection (OR = 6.26, p < 0.0001, I2 = 0%) were significant risk factors. However, age, gender, cup anteversion, femoral osteotomy, vertical (V-COR) centre of rotation, intraoperative fracture, preoperative and postoperative leg length discrepancy (LLD) and previous hip surgery were not found to be significant risk factors.

Conclusion

This study underscores importance of these risk factors in THA planning for DDH patients to reduce dislocation risk. Further research needed to understand mechanisms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

Data available on request from the authors.

Code availability

Not applicable.

References

  1. Gwam CU, Mistry JB, Mohamed NS et al (2017) Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty 32:2088–2092. https://doi.org/10.1016/j.arth.2017.02.046

    Article  PubMed  Google Scholar 

  2. de Palma L, Procaccini R, Soccetti A, Marinelli M (2012) Hospital Cost of Treating Early Dislocation following Hip Arthroplasty. HIP Int 22:62–67. https://doi.org/10.5301/HIP.2012.9059

    Article  PubMed  Google Scholar 

  3. Kunutsor SK, Barrett MC, Beswick AD et al (2019) Risk factors for dislocation after primary total hip replacement: a systematic review and meta-analysis of 125 studies involving approximately five million hip replacements. Lancet Rheumatol 1:e111–e121. https://doi.org/10.1016/S2665-9913(19)30045-1

    Article  PubMed  PubMed Central  Google Scholar 

  4. Faldini C, Stefanini N, Fenga D et al (2018) How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options. J Orthop Traumatol 19:17. https://doi.org/10.1186/s10195-018-0510-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Falez F, Papalia M, Favetti F et al (2017) Total hip arthroplasty instability in Italy. Int Orthop 41:635–644. https://doi.org/10.1007/s00264-016-3345-6

    Article  PubMed  Google Scholar 

  6. Fessy MH, Putman S, Viste A et al (2017) What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips. Orthop Traumatol Surg Res 103:663–668. https://doi.org/10.1016/j.otsr.2017.05.014

    Article  CAS  PubMed  Google Scholar 

  7. Soong M, Rubash HE, Macaulay W (2004) Dislocation After Total Hip Arthroplasty. J Am Acad Orthop Surg 12:314–321. https://doi.org/10.5435/00124635-200409000-00006

    Article  PubMed  Google Scholar 

  8. Ullmark G (2016) The unstable total hip arthroplasty. EFORT Open Rev 1:83–88. https://doi.org/10.1302/2058-5241.1.000022

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ravi B, Jenkinson R, Austin PC et al (2014) Relation between surgeon volume and risk of complications after total hip arthroplasty: propensity score matched cohort study. BMJ 348:g3284–g3284. https://doi.org/10.1136/bmj.g3284

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Mortazavi SMJ, Ghadimi E, Ardakani MV et al (2022) Risk factors of dislocation after total hip arthroplasty in patients with developmental dysplasia of the hip. Int Orthop 46:749–759. https://doi.org/10.1007/s00264-021-05294-w

    Article  PubMed  Google Scholar 

  11. Lo CK-L, Mertz D, Loeb M (2014) Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol 14:45. https://doi.org/10.1186/1471-2288-14-45

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ding Z, Zeng W, Mou P et al (2020) Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip. Orthop Surg 12:589–600. https://doi.org/10.1111/os.12665

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wang L, Trousdale RT, Ai S et al (2012) Dislocation After Total Hip Arthroplasty Among Patients With Developmental Dysplasia of the Hip. J ARTHROPLASTY 27:764–769. https://doi.org/10.1016/j.arth.2011.08.021

    Article  PubMed  Google Scholar 

  14. Komiyama K, Fukushi J, Motomura G et al (2019) Does high hip centre affect dislocation after total hip arthroplasty for developmental dysplasia of the hip? Int Orthop 43:2057–2063. https://doi.org/10.1007/s00264-018-4154-x

    Article  PubMed  Google Scholar 

  15. Yetkin C, Yildirim T, Alpay Y et al (2021) Evaluation of Dislocation Risk Factors With Total Hip Arthroplasty in Developmental Hip Dysplasia Patients: A Multivariate Analysis. J ARTHROPLASTY 36:636–640. https://doi.org/10.1016/j.arth.2020.08.043

    Article  PubMed  Google Scholar 

  16. Ferguson RJ, Palmer AJ, Taylor A et al (2018) Hip replacement. The Lancet 392:1662–1671. https://doi.org/10.1016/S0140-6736(18)31777-X

    Article  Google Scholar 

  17. Kuitunen I, Uimonen MM, Haapanen M et al (2022) Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy: A Systematic Review and Meta-analysis. JAMA Netw Open 5:e2227638. https://doi.org/10.1001/jamanetworkopen.2022.27638

    Article  PubMed  PubMed Central  Google Scholar 

  18. Guo L, Yang Y, An B et al (2017) Risk factors for dislocation after revision total hip arthroplasty: A systematic review and meta-analysis. Int J Surg 38:123–129. https://doi.org/10.1016/j.ijsu.2016.12.122

    Article  PubMed  Google Scholar 

  19. Cross MB, Nam D, Mayman DJ (2012) Ideal Femoral Head Size in Total Hip Arthroplasty Balances Stability and Volumetric Wear. HSS J ® 8:270–274. https://doi.org/10.1007/s11420-012-9287-7

  20. Cameron HU, Botsford DJ, Park YS (1996) Influence of the crowe rating on the outcome of total hip arthroplasty in congenital hip dysplasia. J Arthroplasty 11:582–587. https://doi.org/10.1016/S0883-5403(96)80113-6

    Article  CAS  PubMed  Google Scholar 

  21. Gustke K (2013) The dysplastic hip NOT FOR THE SHALLOW SURGEON. BONE Jt J 95B:31–36. https://doi.org/10.1302/0301-620X.95B11.32899

    Article  Google Scholar 

  22. Wiznia DH, Buchalter DB, Kirby DJ et al (2021) Applying the hip-spine relationship in total hip arthroplasty. HIP Int 31:144–153. https://doi.org/10.1177/1120700020949837

    Article  PubMed  Google Scholar 

  23. Romagnoli M, Grassi A, Costa GG et al (2019) The efficacy of dual-mobility cup in preventing dislocation after total hip arthroplasty: a systematic review and meta-analysis of comparative studies. Int Orthop 43:1071–1082. https://doi.org/10.1007/s00264-018-4062-0

    Article  PubMed  Google Scholar 

  24. Lan Y, Feng E, Lin B et al (2022) Direct anterior versus posteriorlateral approachs for clinical outcomes after total hip arthroplasty in the treatment of severe DDH. BMC Musculoskelet Disord 23:958. https://doi.org/10.1186/s12891-022-05759-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Yang S (2012) Total hip arthroplasty in developmental dysplasia of the hip: Review of anatomy, techniques and outcomes. World J Orthop 3:42. https://doi.org/10.5312/wjo.v3.i5.42

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kosashvili Y, Backstein D, Safir O et al (2011) Dislocation and Infection After Revision Total Hip Arthroplasty. J Arthroplasty 26:1170–1175. https://doi.org/10.1016/j.arth.2011.04.022

    Article  PubMed  Google Scholar 

  27. Lewinnek GE, Lewis JL, Tarr R et al (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60:217–220

    Article  CAS  PubMed  Google Scholar 

  28. Jolles BM, Zangger P, Leyvraz P-F (2002) Factors predisposing to dislocation after primary total hip arthroplasty. J Arthroplasty 17:282–288. https://doi.org/10.1054/arth.2002.30286

    Article  CAS  PubMed  Google Scholar 

  29. on behalf of the Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group, Jørgensen CC, Kjaersgaard-Andersen P, et al (2014) Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors. Arch Orthop Trauma Surg 134:1615–1622. https://doi.org/10.1007/s00402-014-2051-3

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Parmida Shahbazi, Amir Hossein Jalilvand, Amirhossein Ghaseminejad-Raeini, Ali Ghaderi, Mehrdad Sheikhvatan, Yousef Fallah & Seyyed Hossein Shafiei

  2. Heidelberg Medical Hospital, Heidelberg, Germany

    Mehrdad Sheikhvatan

Authors
  1. Parmida Shahbazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amir Hossein Jalilvand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amirhossein Ghaseminejad-Raeini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ali Ghaderi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mehrdad Sheikhvatan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yousef Fallah
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seyyed Hossein Shafiei
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Parmida Shahbazi, Amir Hossein Jalilvand, Amirhossein Ghaseminejad-Raeini and Mehrdad Sheikhvatan. The first draft of the manuscript was written by Parmida Shahbazi, Amir Hossein Jalilvand, Amirhossein Ghaseminejad-Raeini and Ali Ghaderiand all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Seyyed Hossein Shafiei.

Ethics declarations

Consent for publication

Not applicable.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 20 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shahbazi, P., Jalilvand, A.H., Ghaseminejad-Raeini, A. et al. Risk Factors for Dislocation following Total Hip Arthroplasty in Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis. International Orthopaedics (SICOT) 47, 3063–3075 (2023). https://doi.org/10.1007/s00264-023-05949-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-023-05949-w

Keywords

Search

Navigation