PURPOSE: Dislocating hip prosthesis remains a substantial clinical problem. The aim of this study is to describe the risk of recurrent instability after a primary dislocation of primary hip arthroplasty performed for osteoarthritis (OA) or femoral neck fracture (FNF). METHODS: Seventy patients (male/females: 25/45; mean age 77 [range 46-94]) with dislocating hip arthroplasties were included in a prospective cohort study and followed for four years. Radiographs and all surgical records were reviewed. We compared stable hips to those who either continued to dislocate or were revised due to recurrent instability (unstable group). RESULTS: Forty-two hips (60 %) had episodes of recurrent instability leading to repeated closed reductions or major revision surgery and were classified as unstable. A diagnosis of FNF and cognitive dysfunction (OR 9.3 [95 % CI 1.4-64.1]) or postoperative radiological discrepancies such as leg-lengthening and offset reduction increased the risk of further instability (OR 13.5 [95 % CI 1.3-148.1]). The surgical approach at primary surgery and ASA class did not significantly influence the risk of continued instability. CONCLUSIONS: Patients with a FNF and cognitive dysfunction or with sub-optimal postoperative radiographs after hip arthroplasty surgery are at high risk of recurrent instability after a primary dislocation. For hip fracture patients, all efforts should be made to avoid the first dislocation.
PURPOSE: Dislocating hip prosthesis remains a substantial clinical problem. The aim of this study is to describe the risk of recurrent instability after a primary dislocation of primary hip arthroplasty performed for osteoarthritis (OA) or femoral neck fracture (FNF). METHODS: Seventy patients (male/females: 25/45; mean age 77 [range 46-94]) with dislocating hip arthroplasties were included in a prospective cohort study and followed for four years. Radiographs and all surgical records were reviewed. We compared stable hips to those who either continued to dislocate or were revised due to recurrent instability (unstable group). RESULTS: Forty-two hips (60 %) had episodes of recurrent instability leading to repeated closed reductions or major revision surgery and were classified as unstable. A diagnosis of FNF and cognitive dysfunction (OR 9.3 [95 % CI 1.4-64.1]) or postoperative radiological discrepancies such as leg-lengthening and offset reduction increased the risk of further instability (OR 13.5 [95 % CI 1.3-148.1]). The surgical approach at primary surgery and ASA class did not significantly influence the risk of continued instability. CONCLUSIONS:Patients with a FNF and cognitive dysfunction or with sub-optimal postoperative radiographs after hip arthroplasty surgery are at high risk of recurrent instability after a primary dislocation. For hip fracturepatients, all efforts should be made to avoid the first dislocation.
Authors: Aaron H Carter; Eoin C Sheehan; S M Javad Mortazavi; James J Purtill; Peter F Sharkey; Javad Parvizi Journal: J Arthroplasty Date: 2011-05-08 Impact factor: 4.757
Authors: Philippe Hernigou; Louis Ratte; François Roubineau; Jacques Pariat; Guillaume Mirouse; Isaac Guissou; Jerome Allain; Charles Henri Flouzat Lachaniette Journal: Int Orthop Date: 2013-05-12 Impact factor: 3.075
Authors: Marion Opperer; Yuo-yu Lee; Francisco Nally; Alvaro Blanes Perez; Kaveh Goudarz-Mehdikhani; Alejandro Gonzalez Della Valle Journal: Int Orthop Date: 2015-10-27 Impact factor: 3.075
Authors: Dan-Viorel Nistor; Sergiu Caterev; Sorana-Daniela Bolboacă; Dan Cosma; Dan Osvald Gheorghe Lucaciu; Adrian Todor Journal: Int Orthop Date: 2017-04-24 Impact factor: 3.075
Authors: Angela Maria Paiva Magri; Kelly Rossetti Fernandes; Hueliton Wilian Kido; Gabriela Sodano Fernandes; Stephanie de Souza Fermino; Paulo Roberto Gabbai-Armelin; Franscisco José Correa Braga; Cintia Pereira de Góes; José Lucas Dos Santos Prado; Renata Neves Granito; Ana Claudia Muniz Rennó Journal: Laser Ther Date: 2019-09-30