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Reducing the rate of early primary hip dislocation by combining a change in surgical technique and an increase in femoral head diameter to 36 mm

  • Hip Arthroplasty
  • Published:
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Abstract

Introduction

We report how changes to our total hip arthroplasty (THA) surgical practise lead to a decrease in early hip dislocation rates.

Methods

Group B consisted of 421 consecutive primary THA operations performed via a posterior approach. The operative technique included a meticulous repair of the posterior capsule, alignment of the acetabular cup with the transverse acetabular ligament (TAL) and a 36-mm-diameter femoral head. We compared the dislocation rates and cost implications of this technique to a historical control Group A consisting of 389 patients. The control group had their THA performed with no repair of the capsule, no identification of the TAL and all received a 28-mm-diameter head. Our primary outcome is the rate of early hip dislocation and we hypothesised that we can reduce the rate of early hip dislocation with this new regime.

Results

In Group B there were no early dislocations (within 6 months) and two (0.5 %) dislocations within 18 months; minimum follow-up time was 18 months with a range of (18–96 months). This compared to a 1.8 % early dislocation rate and a 2.6 % rate at 18 months in Group A; minimum follow-up time was 60 months with a range of (60–112 months). These results were statistically significant (p = 0.006).

Conclusion

We suggest that when primary hip arthroplasty is performed through a posterior approach, a low early dislocation rate can be achieved using the described methods.

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Conflict of interest

No author has or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Worcestershire Royal Hospital, Worcester, UK

    Ki Wai Kevin Ho

  2. Department of Orthopaedic Surgery, Warwick Hospital, South Warwickshire NHS Foundation Trust, Warwick, UK

    Ki Wai Kevin Ho, George S. Whitwell & Steve K. Young

  3. 6 Bollington Close, Prenton, CH43 2GT, UK

    Ki Wai Kevin Ho

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  1. Ki Wai Kevin Ho
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  2. George S. Whitwell
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Correspondence to Ki Wai Kevin Ho.

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Ho, K.W.K., Whitwell, G.S. & Young, S.K. Reducing the rate of early primary hip dislocation by combining a change in surgical technique and an increase in femoral head diameter to 36 mm. Arch Orthop Trauma Surg 132, 1031–1036 (2012). https://doi.org/10.1007/s00402-012-1508-5

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  • DOI: https://doi.org/10.1007/s00402-012-1508-5

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