J Korean Hip Soc.  2011 Jun;23(2):89-94. 10.5371/jkhs.2011.23.2.89.

Dislocation as a Complication after Total Hip Arthroplasty

• Kim JS

• KMID: 2190718
• DOI: http://doi.org/10.5371/jkhs.2011.23.2.89

Abstract

The prevalence of reoperation due to dislocation after total hip arthroplasty ranks high because of aseptic loosening, periprosthetic fracture and infection. Dislocation occurs in 0.5% to 4% of the cases in a year after primary total hip arthroplasty. The risk of dislocation is influenced by the position of the components, the surgical approach, the surgical techniques, the design of the prosthesis, the underlying diagnosis and the patient's compliance with restrictions. A better understanding of the etiology of dislocation and refinements of surgical techniques have led to a decrease in the rate of dislocation over time. Although most dislocations after total hip arthroplasty are a single episode that can be managed nonoperatively, some patients require surgical intervention to treat recurrent dislocation. The choice of surgical technique to manage recurrent dislocation depends on the etiology of the problem. The surgical options available for the treatment of recurrent dislocation consist of component revision, modular component exchange, use of a larger femoral head, soft tissue reinforcement, advancement of the greater trochanter, bipolar arthroplasty and use of a constrained liner.

Keyword

Dislocation; Total hip arthroplasty

MeSH Terms

Arthroplasty
Compliance
Dislocations
Femur
Head
Hip
Humans
Periprosthetic Fractures
Prevalence
Prostheses and Implants
Reinforcement (Psychology)
Reoperation

Figure

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  Fig. 1 Mechanism by which pelvic rotation during the operation may lead to retroversion of the acetabular component.

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  Fig. 2 After completing the total hip arthroplasty, the posterior capsule and the short external rotators were repaired.

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  Fig. 3 Skirted heads lead to impingement and have a negative impact on range of motion. (A) skirted head. (B) head without skirt.

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  Fig. 4 The patient took clothes from floor using a reacher.

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