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International Orthopaedics

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01-06-2015 | Original Paper

Unstable hip arthroplasties. A prospective cohort study on seventy dislocating hips followed up for four years

Authors: Olle Wallner, André Stark, Olle Muren, Thomas Eisler, Olof Sköldenberg

Published in: International Orthopaedics | Issue 6/2015

Abstract

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.

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Title: Unstable hip arthroplasties. A prospective cohort study on seventy dislocating hips followed up for four years
Authors: Olle Wallner
André Stark
Olle Muren
Thomas Eisler
Olof Sköldenberg
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 6/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2583-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Unstable hip arthroplasties. A prospective cohort study on seventy dislocating hips followed up for four years

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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