BACKGROUND: Despite dislocation being the most frequent complication after revision THA, risk factors for its occurrence are not completely understood. QUESTIONS/PURPOSES: We therefore (1) determined the overall risk of dislocation after revision THA in a large series of revision THAs using contemporary revision techniques, (2) identified patient-related risk factors predicting dislocation, and (3) identified surgical variables predicting dislocation. METHODS: We performed 1211 revision THAs between June 2004 and October 2010 in 576 women and 415 men who had a mean age of 64.7 years (range, 25-95 years) at time of surgery. Forty-six (4%) were lost to followup and 13 died (1%), leaving 1152 hips followed for a minimum of 90 days (mean, 2 years; range, 90 days to 7.1 years). Multivariate logistic regression was performed to identify risk factors for dislocation. The model was also tested on patients followed for a minimum 1 year to assess any difference in longer followup. RESULTS: One hundred thirteen patients dislocated over the followup period (9.8%). Factors that were different between patients who dislocated and those who remained stable included a history of at least one previous dislocation (odds ratio [OR] = 2.673), abductor deficiency (OR = 2.672), and Paprosky acetabulum class (OR = 1.522). Use of a constrained liner (OR = 0.503) and increased femoral head size (OR = 0.942) were protective against dislocation, while with longer followup a constrained liner was no longer significant. CONCLUSIONS: Dislocation remains a common problem after revision THA. Identifying these risk factors can assist in patient education and surgical planning. Recognition of these risk factors in both patient type and surgical strategy is important for the surgeon performing revision THA and for minimizing these risks. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
BACKGROUND: Despite dislocation being the most frequent complication after revision THA, risk factors for its occurrence are not completely understood. QUESTIONS/PURPOSES: We therefore (1) determined the overall risk of dislocation after revision THA in a large series of revision THAs using contemporary revision techniques, (2) identified patient-related risk factors predicting dislocation, and (3) identified surgical variables predicting dislocation. METHODS: We performed 1211 revision THAs between June 2004 and October 2010 in 576 women and 415 men who had a mean age of 64.7 years (range, 25-95 years) at time of surgery. Forty-six (4%) were lost to followup and 13 died (1%), leaving 1152 hips followed for a minimum of 90 days (mean, 2 years; range, 90 days to 7.1 years). Multivariate logistic regression was performed to identify risk factors for dislocation. The model was also tested on patients followed for a minimum 1 year to assess any difference in longer followup. RESULTS: One hundred thirteen patients dislocated over the followup period (9.8%). Factors that were different between patients who dislocated and those who remained stable included a history of at least one previous dislocation (odds ratio [OR] = 2.673), abductor deficiency (OR = 2.672), and Paprosky acetabulum class (OR = 1.522). Use of a constrained liner (OR = 0.503) and increased femoral head size (OR = 0.942) were protective against dislocation, while with longer followup a constrained liner was no longer significant. CONCLUSIONS: Dislocation remains a common problem after revision THA. Identifying these risk factors can assist in patient education and surgical planning. Recognition of these risk factors in both patient type and surgical strategy is important for the surgeon performing revision THA and for minimizing these risks. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
Authors: Trevor G Murray; Nathan G Wetters; Mario Moric; Scott M Sporer; Wayne G Paprosky; Craig J Della Valle Journal: J Arthroplasty Date: 2012-05-17 Impact factor: 4.757
Authors: Nizar N Mahomed; Jane A Barrett; Jeffrey N Katz; Charlotte B Phillips; Elena Losina; Robert A Lew; Edward Guadagnoli; William H Harris; Robert Poss; John A Baron Journal: J Bone Joint Surg Am Date: 2003-01 Impact factor: 5.284
Authors: Matthew W Tetreault; Sanjai K Shukla; Paul H Yi; Scott M Sporer; Craig J Della Valle Journal: Clin Orthop Relat Res Date: 2014-02 Impact factor: 4.176
Authors: Matthew P Abdel; Philipp von Roth; Matthew T Jennings; Arlen D Hanssen; Mark W Pagnano Journal: Clin Orthop Relat Res Date: 2016-02 Impact factor: 4.176
Authors: P M Prodinger; J Schauwecker; H Mühlhofer; N Harrasser; F Pohlig; C Suren; R von Eisenhart-Rothe Journal: Orthopade Date: 2017-02 Impact factor: 1.087
Authors: Francisco Xará-Leite; Ana Daniela Pereira; Renato Andrade; André Sarmento; Ricardo Sousa; Olufemi R Ayeni; João Espregueira-Mendes; Daniel Soares Journal: Eur J Orthop Surg Traumatol Date: 2020-07-14