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Re-dislocation after revision total hip arthroplasty for recurrent dislocation: a multicentre study

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Abstract

Purpose

Although most case of dislocations after total hip arthroplasty (THA) can be managed with conservative treatment, recurrent dislocation may require surgical intervention. This multicentre study was conducted to evaluate the re-dislocation rate after revision THA for recurrent dislocation, and to determine the risk factors for re-dislocation.

Methods

We retrospectively reviewed the 88 hips in 88 patients who underwent revision THA for recurrent dislocation at five institutions between 1995 and 2014. The mean patient age at surgery was 68.5 years and the mean follow-up period was 53.1 months. Multivariate logistic regression was performed to identify risk factors for re-dislocation.

Results

Sixteen hips in 16 patients (18.2 %) re-dislocated at a mean of 25.5 months (range, 1–83 months) after revision THA. Multivariate analysis identified osteonecrosis of the femoral head (odds ratio [OR] = 5.62 vs. osteoarthritis) and a femoral head size < 32 mm (OR = 3.86) as independent risk factors for re-dislocation. Eight hips required additional revision THA for re-dislocation.

Conclusion

The re-dislocation rate after revision THA for recurrent dislocation remains high, suggesting the need for prevention measures. We recommend the use of a femoral head size ≥ 32 mm.

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Acknowledgments

This work was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (No. 15 K10450). We thank Junji Kishimoto, a statistician from the Digital Medicine Initiative, Kyushu University, for his valuable comments and suggestions in regards to the statistical analysis. The authors certify that they have no commercial associations that might pose a conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kensei Yoshimoto, Yasuharu Nakashima & Yukihide Iwamoto

  2. Department of Orthopaedics, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Shigeo Aota

  3. Department of Orthopaedic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahokugun, Ishikawa, 920-0293, Japan

    Ayumi Kaneuji & Kiyokazu Fukui

  4. Shonan Kamakura Joint Reconstruction Center, 5-4-17 Dai, Kamakura, Kanagawa, 247-0061, Japan

    Kazuo Hirakawa & Nariaki Nakura

  5. Department of Orthopaedic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0133, Japan

    Koichi Kinoshita & Masatoshi Naito

Authors
  1. Kensei Yoshimoto
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  2. Yasuharu Nakashima
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  3. Shigeo Aota
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  4. Ayumi Kaneuji
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  5. Kiyokazu Fukui
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  6. Kazuo Hirakawa
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  7. Nariaki Nakura
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  8. Koichi Kinoshita
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  9. Masatoshi Naito
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  10. Yukihide Iwamoto
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Corresponding author

Correspondence to Yasuharu Nakashima.

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Yoshimoto, K., Nakashima, Y., Aota, S. et al. Re-dislocation after revision total hip arthroplasty for recurrent dislocation: a multicentre study. International Orthopaedics (SICOT) 41, 253–258 (2017). https://doi.org/10.1007/s00264-016-3127-1

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  • DOI: https://doi.org/10.1007/s00264-016-3127-1

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