J Korean Hip Soc.  2011 Sep;23(3):169-173. 10.5371/jkhs.2011.23.3.169.

The Causes and Treatment of Dislocations after Total Hip Arthroplasty

• So KY
• Chung YY

• KMID: 2014882
• DOI: http://doi.org/10.5371/jkhs.2011.23.3.169

Abstract

A dislocation after total hip arthroplasty is a serious complication that is related to the component position and poor patient compliance. Therefore, the attendants and surgeons need to be aware of the risk factors for dislocations and take steps to prevent them. In addition, the surgeon should insert the components within the safe zone. The patients should also be informed of possibility of dislocations after total hip arthroplasty. Dislocations can be treated conservatively but a recurrent dislocation requires surgery. The causes of recurrent dislocations must be evaluated before surgery to achieve a high success rate.

Keyword

Total hip arthroplasty; Dislocation; Complication

MeSH Terms

Arthroplasty
Dislocations
Hip
Humans
Patient Compliance
Risk Factors

Reference

1. Daly PJ, Morrey BF. Operative correction of an unstable total hip arthroplasty. J Bone Joint Surg Am. 1992. 74:1334–1343.

2. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978. 60:217–220.

3. Ali Khan MA, Brakenbury PH, Reynolds IS. Dislocation following total hip replacement. J Bone Joint Surg Br. 1981. 63-B:214–218.

4. Fackler CD, Poss R. Dislocation in total hip arthroplasties. Clin Orthop Relat Res. 1980. 151:169–178.

5. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am. 1982. 64:1295–1306.

6. Ekelund A, Rydell N, Nilsson OS. Total hip arthroplasy in patients 80 years of age and older. Clin Orthop Relat Res. 1992. 281:101–106.

7. Iorio R, Healy WL, Lemos DW, Appleby D, Lucchesi CA, Saleh KJ. Displaced femoral neck fractures in the elderly: outcomes and cost effectiveness. Clin Orthop Relat Res. 2001. 383:229–242.

8. Lee BP, Berry DJ, Harmsen WS, Sim FH. Total hip arthroplasty for the treatment of an acute fracture of the femoral neck: long-term results. J Bone Joint Surg Am. 1998. 80:70–75.

9. Alberton GM, High WA, Morrey BF. Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg Am. 2002. 84-A:1788–1792.

10. Hedlundh U, Fredin H. Patient characteristics in dislocations after primary total hip arthroplasty. 60 patients compared with a control group. Acta Orthop Scand. 1995. 66:225–228.

11. Woolson ST, Rahimtoola ZO. Risk factors for dislocation during the first 3 months after primary total hip replacement. J Arthroplasty. 1999. 14:662–668.

12. Morrey BF. Difficult complications after hip joint replacement. Dislocation. Clin Orthop Relat Res. 1997. 344:179–187.

13. Roberts JM, Fu FH, McClain EJ, Ferguson AB Jr. A comparison of the posterolateral and anterolateral approaches to total hip arthroplasty. Clin Orthop Relat Res. 1984. 187:205–210.

14. Kim KS, Ko SH, Kim KJ, Kim HS, Sung CM, Oh SI. Clinical and radiological analysis of THR using AML prosthesis. J Korean Orthop Assoc. 1994. 29:567–576.

15. Kim KS, Ko SH, Chung YY, et al. Total hip arthroplasty with hydroxyapatite-coated ABG prosthesis. J Korean Orthop Assoc. 2003. 38:568–572.

16. Pellicci PM, Bostrom M, Poss R. Posterior approach to total hip replacement using enhanced posterior soft tissue repair. Clin Orthop Relat Res. 1998. 355:224–228.

17. Suh KT, Park BG, Choi YJ. A posterior approach to primary total hip arthroplasty with soft tissue repair. Clin Orthop Relat Res. 2004. 418:162–167.

18. Kwon MS, Kuskowski M, Mulhall KJ, Macaulay W, Brown TE, Saleh KJ. Does surgical approach affect total hip arthroplasty dislocation rates? Clin Orthop Relat Res. 2006. 447:34–38.

19. Biedermann R, Tonin A, Krismer M, Rachbauer F, Eibl G, Stöckl B. Reducing the risk of dislocation after total hip arthroplasty: the effect of orientation of the acetabular component. J Bone Joint Surg Br. 2005. 87:762–769.

20. Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement. J Bone Joint Surg Am. 2007. 89:1832–1842.

21. Kelley SS, Lachiewicz PF, Hickman JM, Paterno SM. Relationship of femoral head and acetabular size to the prevalence of dislocation. Clin Orthop Relat Res. 1998. 355:163–170.

22. Cobb TK, Morrey BF, Ilstrup DM. The elevated-rim acetabular liner in total hip arthroplasty: relationship to postoperative dislocation. J Bone Joint Surg Am. 1996. 78:80–86.

23. Krushell RJ, Burke DW, Harris WH. Elevated-rim acetabular components. Effect on range of motion and stability in total hip arthroplasty. J Arthroplasty. 1991. 6:Suppl. S53–S58.

24. Clayton ML, Thirupathi RG. Dislocation following total hip arthroplasty. Management by special brace in selected patients. Clin Orthop Relat Res. 1983. 177:154–159.

25. Mallory TH, Vaughn BK, Lombardi AV Jr, Kraus TJ. Prophylactic use of a hip cast-brace following primary and revision total hip arthroplasty. Orthop Rev. 1988. 17:178–183.

26. Dewal H, Maurer SL, Tsai P, Su E, Hiebert R, Di Cesare PE. Efficacy of abduction bracing in the management of total hip arthroplasty dislocation. J Arthroplasty. 2004. 19:733–738.

27. Beaulé PE, Schmalzried TP, Udomkiat P, Amstutz HC. Jumbo femoral head for the treatment of recurrent dislocation following total hip replacement. J Bone Joint Surg Am. 2002. 84-A:256–263.

28. Muratoglu OK, Bragdon CR, O'Connor D, et al. Larger diameter femoral heads used in conjunction with a highly cross-linked ultra-high molecular weight polyethylene: a new concept. J Arthroplasty. 2001. 16:Suppl 1. 24–30.

29. Smith TM, Berend KR, Lombardi AV Jr, Emerson RH Jr, Mallory TH. Metal-on-metal total hip arthroplasty with large heads may prevent early dislocation. Clin Orthop Relat Res. 2005. 441:137–142.

30. Callaghan JJ, O'Rourke MR, Goetz DD, Lewallen DG, Johnston RC, Capello WN. Use of a constrained tripolar acetabular liner to treat intraoperative instablilty and postoperative dislocation after total hip arthroplasty: a review of our experience. Clin Orthop Relat Res. 2004. 429:117–123.

31. Goetz DD, Capello WN, Callaghan JJ, Brown TD, Johnston RC. Salvage of total hip instability with a constrained acetabular component. Clin Orthop Relat Res. 1998. 355:171–181.

32. Harman MK, Hodge WA, Banks SA. Closed reduction of constrained total hip arthroplasty. Clin Orthop Relat Res. 2003. 414:121–128.

33. Anderson MJ, Murray WR, Skinner HB. Constrained acetabular components. J Arthroplasty. 1994. 9:17–23.