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  • Title: 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.
    Author: Ho KW, Whitwell GS, Young SK.
    Journal: Arch Orthop Trauma Surg; 2012 Jul; 132(7):1031-6. PubMed ID: 22460352.
    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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