García-Rey E, García-Cimbrelo E

Language: Spanish
References: 32
Page: 1-17
PDF size: 477.12 Kb.

ABSTRACT

Introduction: The dislocation of the total hip replacement can affect the results of the implant, the quality of life of the patient, and the cost of the process. Its etiology is multifactorial.
Objectives: To identify possible risk factors related to the appearance of dislocation in total hip replacement in a series of cases.
Methods: In a series of 2732 total hip prostheses, in which there were 92 dislocations (3.4%), factors related to the patient, the implant, and the surgical technique used at La Paz-IDIPaz Hospital in Madrid were compared, from 2000 to 2016. Regression analysis was used for the significance of these factors.
Results: Out of 92 dislocations, 62 were treated conservatively (67.4%) and 30 patients required revision surgery (32.6%). The multivariate study showed statistical significance in the following risk factors: state of the lumbar spine (p <0.001), and poor reconstruction of the center of rotation of the hip (p = 0.035), and domes positioned outside Lewinnek windows (p <0.001) and the abductor mechanism (p <0.001) in relation to the surgical technique. There were no significant factors in relation to the type of implant, diameter of the femoral head or friction torque.
Conclusions: Lumbar pathology increases the risk of dislocation in total hip replacement. Proper hip reconstruction, including the position of the dome and the center of rotation of the hip, as well as the abductor mechanism, would help to improve the rate of instability.

REFERENCES

1. Sanchez-Sotelo J, Haidukewych GJ, Boberg CJ, Hospital cost of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am. 2006;88:290-4.

2. Seagrave KG, Troelsen A, Malchau H, Husted H, Gromov K. Acetabular cup position and risk of dislocation in primary total hip arthroplasty, Acta Orthop. 2017;88:1:10-7. DOI: https://doi.org/10.1080/17453674.2016.1251255

3. Rowan FE, Benjamin B, Pietrak JR, Haddad FS. Prevention of dislocation after total hip arthroplasty. J Arthroplasty. 2018;31:1316-24.

4. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60-A:217-20.

5. Berry DJ, Von Knoch M, Schleck CD, Harmsen WS. Effect of femoral head diameter and operative approach on risk of dislocation after total hip arthroplasty. J Bone Joint Surg Am. 2005;87:2456-63.

6. Hailer NP, Weiss RJ, Stark A, Kärrholm J. The risk of revision due to dislocation after total hip arthroplasty depends on surgical approach, femoral head size, sex, and primary diagnosis. An analysis if 78,098 operations in the Swedish Hip Arthroplasty Register. Acta Orthop. 2012;83:442-8.

7. 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-B:762-9

8. García-Rey E, García-Cimbrelo E. Abductor biomechanics clinically impact the total hip arthroplasty dislocation rate: A Prospective Long-Term Study. J Arthroplasty. 2016;31:484-90.

9. Berry DJ, von Knoch M, Schleck CD, Harmsen WS. The cumulative long-term risk of dislocation after primary Charnley total hip arhtroplasty. J Bone Joint Surg Am. 2004;86-A:9-14.

10. Norambuena GA, Wyles CC, Van Demark RE 3rd, Trousdale RT. Effect of dislocation timing following primary total hip arthroplasty on the risk of redislocation and revision. Hip Inter. 2019;29:489-95.

11. Herman A, Masri BA, Duncan CP, Greidanus NV, Garbuz DS. Multivariate analysis of risk factors for re-dislocation after revision for dislocation after total hip arthroplasty. Hip Inter. 2020;30:93-100.

12. Widmer KH. A simplified method to determine acetabular cup anteversion from plain radiographs. J Arthroplasty. 2004;19:387-90.

13. Johnston RC, Fitzgerald RH, Harris WH, Poss R, Müller ME, Sledge CB. Clinical and radiographic evaluation of total hip arthroplasty: a standard system of terminology for reporting results. J BoneJointSurg Am. 1990;72-A:161-8.

14. Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusioacetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62:1059-65.

15. Devane PA, Home JG, Martin K, Coldham G, Krause B. Three-dimensional polyethylene wear of a press-fit titanium prosthesis: factors influencing generation of polyethylene debris. J Arthroplasty. 1997;12:256-66.

16. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surgery Am. 2009;91-A:128-33.

17. An VV, Phan K, Sivakumar BS, Mobbs RJ, Bruce WJ. Prior lumbar spinal fusion is associated with an increased risk of dislocation and revision in total hip arthroplasty: a meta-analysis. J Arthroplasty. 2018;33:297-300.

18. Heckmann N, McKnight B, Stefl M, Trasolini NA, Ike H, Dorr LD. Late dislocation following total hip arthroplasty: spinopelvic imbalance as a causative factor. J Bone Joint Surg Am. 2018;100:1845-54.

19. Lazennec JY, Clark IC, Folinais D, Tahar IN, Pour AE. What is the impact of a spinal fusion on acetabular implant orientation in functional standing and sitting positions? J Arthroplasty. 2017;32:3184-90.

20. Esposito CI, Carroll KM, Sculco PK, Padgett DE, Jerabek SA, Mayman DJ. Total hip arthroplasty patients with fixed spinopelvic alignment are at higher risk of hip dislocation. J Arthroplasty. 2018;33:1449-54.

21. Buckland AJ, Puvanesaarajah V, Vigdorchik J, Schwarzkopf, Jain A, Klineberg EO, et al. Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint Journal. 2017;99-B:585-91.

22. Terrier A, Florencio FL, Rüdinger HA. Benefit of cup medialization in total hip arthroplasty is associated with femoral anatomy. Clin Orthop Relat Res. 2014;472:3159-65.

23. Pedneault C, Tanzer D, Nooh A, Smith K,Tanzer M. Capsular closure outweighs head size in preventing dislocation following revision total hip arthroplasty. Hip Inter. 2020;30:141-6.

24. Kumar V, Sharma S, James J, Hodgkinson, Hemmady MV. Total hip replacement through a posterior approach using a 22-mm diameter femoral head. Bone Joint J. 2014;96-B:1202-6.

25. Hernigou P, Homma Y, Pidet O, Guissou I, Hernigou J. Ceramic-on ceramic bearing decreases the cumulative long-term risk of dislocation. Clin Orthop Relat Res. 2013;471:3875-82.

26. White RE Jr, Forness TJ, Allman JK, Junick DW. Effect of posterior capsular repair on early dislocation in primary total hip replacement. Clin Orthop Relat Res. 2001;(393):163-7.

27. Callanan MC, Jarrett B, Bragdon CR, Zurakowski D, Rubash HE, Freiberg AA, Malchau H. Risk factors for cup malpositioning. Quality improvement through a joint registry as a tertiary hospital. Clin Orthop Relat Res. 2011;469:319-29.

28. Pierchon F, Pasquier G, Cotton A, Fontaine C, Clarisse J, Duquennoy A. Causes of dislocation of total hip arthroplasty. CT study of component alignment. J Bone Joint Surg Br. 1994;76:45-8.

29. Huten D, Fournier Y, Gicquel T, Berthoa P, Basselot F, Hamadouche M. Risk factors for dislocation after revision total hip arthroplasty with a dual-mobility cup. Matched case-control study (16 cases vs. 48 controls). Orthop Traum Surg Res. 2019;105:1303-9.

30. Esposito CI, Gladnik BP, Lee Y, Lyman S, Wright TM, Maynam DJ, Padgett DE. Cup position alone does not predict risk of dislocation after hip arthroplasty. J Arthroplasty. 2015;30:109-13.

31. Grammatopoulos G, Thomas GE, Pandit H, Beard DJ, Gill HS, Murray DW. The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings. Bone Joint J. 2015;97-B:164-72.

32. McGrory BJ, Morrey BF, Cahalan TD, An KN, Cabanela ME. Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty. J Bone Joint Surg Br. 1995;77-B:865-9.