Abstract
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 January 1, 2008, to December 31, 2009, with addresses in the Wellington region. The mean age was 67.5 years (range, 27–96 years). The minimum followup was 2 years (mean, 3 years; range, 2–4 years).
Results
Six patients required revision of at least one component for dislocation. There was 100% agreement between the hospital database and the NJR. Using the NJR criteria of revision of any component as an end point, the dislocation rate in the Wellington region after primary THA was 1.05%. The hospital database identified a further eight patients who presented with a dislocation of their primary THA and underwent a closed reduction. These patients were not recorded by the NJR. The true rate of all dislocations, which includes closed reductions, was 2.46%.
Conclusions
This article documents the discrepancy between the NZ NJR reported rate of revision for dislocation and the true rate of dislocation in primary THA. We recommend documentation of all dislocations by NJR in their database to allow more accurate comparisons between centers and research outcomes.
Level of Evidence
Level IV, clinical research study. See Guidelines for Authors for a complete description of levels of evidence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ali Khan MA, Brakenbury PH, Reynolds IS. Dislocation following total hip replacement. J Bone Joint Surg Br. 1981;63:214–218.
Australian Orthopedic Association. National joint replacement registry annual report 2010. Available at: http://www.dmac.Adelaide.edu.au/aoanjrr/documents/AnnualReports2011/AnnualReport_2011_WebVersion.pdf. 2011;1–201. Accessed January 16, 2012.
Chandler H, Dorr LD, Perry J. The functional cost of dislocation following total hip arthroplasty. Clin Orthop Relat Res. 1982;168:168–172.
Garellick G, Karrholm J, Rogmark C, Herberts P. Swedish Hip Arthroplasty Register Annual Report 2009. Available at: http://www.shpr.se/Libraries/Documents/AnnualReport-2009-EN.sflb.ashx. 2010;1–104. Accessed January 16, 2012.
Hedlundh U, Fredin H. Patient characteristics in dislocations after primary total hip arthroplasty. 60 patients compared with a control group. Acta Orthop Scand. 1995;66:225–228.
Helse Bergen H. The Norwegian arthroplasty registry report 2010. Available at: http://nrlweb.ihelse.net/eng/Report_2010.pdf. 2010;1–187. Accessed January 16, 2012.
Mahoney CR, Pellicci PM. Complications in primary total hip arthroplasty: avoidance and management of dislocations. Instr Course Lect. 2003;52:247–255.
Malkani AL, Ong KL, Lau E, Kurtz SM, Justice BJ, Manley MT. Early- and late-term dislocation risk after primary hip arthroplasty in the Medicare population. J Arthroplasty. 2010;25:21–25.
Masonis JL, Bourne RB. Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res. 2002;405:46–53.
Meek RM, Allan DB, McPhillips G, Kerr L, Howie CR. Epidemiology of dislocation after total hip arthroplasty. Clin Orthop Relat Res. 2006;447:9–18.
New Zealand Orthopedic Association. The New Zealand joint registry twelve year report. Available at: http://www.cdhb.govt.nz/njr/reports/A2D65CA3.pdf. 2011;1–139. Accessed January 16, 2012.
Newington DP, Bannister GC, Fordyce M. Primary total hip replacement in patients over 80 years of age. J Bone Joint Surg Br.1990;72:450–452.
Padgett DE, Warashina H. The unstable total hip replacement. Clin Orthop Relat Res. 2004;420:72–79.
Pulido L, Restrepo C, Parvizi J. Late instability following total hip arthroplasty. Clin Med Res. 2007;5:139–142.
Ring PA. Total replacement of the hip joint. J Bone Joint Surg Br. 1974;56:44.
Sanchez-Sotelo J, Haidukewych GJ, Boberg CJ. Hospital cost of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am. 2006;88:290–294.
Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am. 1982;64:1295–1306.
Acknowledgments
We thank the surgeons of the Wellington region for allowing us access to their NJR data (anonymous), the IT staff at Wellington Hospital, and the staff of the NZ NJR in Christchurch, specifically Toni Hobbs and Professor Alastair Rothwell.
Author information
Authors and Affiliations
Corresponding author
Additional information
Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patient or licensing arrangements etc) that may pose a conflict of interest with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his institution approved the human protocol for this investigation and that all investigations were conducted in conformity with the ethical principles of research.
About this article
Cite this article
Devane, P.A., Wraighte, P.J., Ong, D.C.G. et al. Do Joint Registries Report True Rates of Hip Dislocation?. Clin Orthop Relat Res 470, 3003–3006 (2012). https://doi.org/10.1007/s11999-012-2323-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11999-012-2323-6