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Clinical Orthopaedics and Related Research®

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01-02-2013 | Symposium: Papers Presented at the Annual Meetings of The Hip Society

Risk Factors for Dislocation After Revision Total Hip Arthroplasty

Authors: Nathan G. Wetters, BS, Trevor G. Murray, MD, Mario Moric, MS, Scott M. Sporer, MD, Wayne G. Paprosky, MD, Craig J. Della Valle, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2013

Abstract

Background

Despite dislocation being the most frequent complication after revision THA, risk factors for its occurrence are not completely understood.

Questions/purposes

We therefore (1) determined the overall risk of dislocation after revision THA in a large series of revision THAs using contemporary revision techniques, (2) identified patient-related risk factors predicting dislocation, and (3) identified surgical variables predicting dislocation.

Methods

We performed 1211 revision THAs between June 2004 and October 2010 in 576 women and 415 men who had a mean age of 64.7 years (range, 25–95 years) at time of surgery. Forty-six (4%) were lost to followup and 13 died (1%), leaving 1152 hips followed for a minimum of 90 days (mean, 2 years; range, 90 days to 7.1 years). Multivariate logistic regression was performed to identify risk factors for dislocation. The model was also tested on patients followed for a minimum 1 year to assess any difference in longer followup.

Results

One hundred thirteen patients dislocated over the followup period (9.8%). Factors that were different between patients who dislocated and those who remained stable included a history of at least one previous dislocation (odds ratio [OR] = 2.673), abductor deficiency (OR = 2.672), and Paprosky acetabulum class (OR = 1.522). Use of a constrained liner (OR = 0.503) and increased femoral head size (OR = 0.942) were protective against dislocation, while with longer followup a constrained liner was no longer significant.

Conclusions

Dislocation remains a common problem after revision THA. Identifying these risk factors can assist in patient education and surgical planning. Recognition of these risk factors in both patient type and surgical strategy is important for the surgeon performing revision THA and for minimizing these risks.

Level of Evidence

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Title: Risk Factors for Dislocation After Revision Total Hip Arthroplasty
Authors: Nathan G. Wetters, BS
Trevor G. Murray, MD
Mario Moric, MS
Scott M. Sporer, MD
Wayne G. Paprosky, MD
Craig J. Della Valle, MD
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 2/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2561-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk Factors for Dislocation After Revision Total Hip Arthroplasty

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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