• Ki Wai Kevin Ho, George S Whitwell, and Steve K Young.
• Worcestershire Royal Hospital, Worcester, UK. kevinho@btinternet.com
• Arch Orthop Trauma Surg. 2012 Jul 1;132(7):1031-6.

IntroductionWe report how changes to our total hip arthroplasty (THA) surgical practise lead to a decrease in early hip dislocation rates.MethodsGroup 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.ResultsIn 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).ConclusionWe suggest that when primary hip arthroplasty is performed through a posterior approach, a low early dislocation rate can be achieved using the described methods.

24 keywords...

hide…