Article

Dislocation rate after hip arthroplasty within the first postoperative year: 36 mm versus 28 mm femoral heads. Hip Int

Department of Orthopaedics and Traumatology, CTO Hospital, Turin, Italy.
Hip international: the journal of clinical and experimental research on hip pathology and therapy (Impact Factor: 0.76). 09/2011; 21(5):559-64. DOI: 10.5301/HIP.2011.8647
Source: PubMed

ABSTRACT Dislocation is a common and important complication of total hip arthroplasty (THA). Larger femoral heads may reduce the risk of dislocation and improve the range of movement. The aim of this study was to compare the relative risk (RR) of dislocation during the first year after THA between implants with 28 mm and 36 mm femoral heads. 198 consecutive hips with 28 mm femoral head (Group-28) and 259 hips with 36 mm femoral head (Group-36) were studied. The patients were assessed preoperatively and periodically using the Harris hip score (HHS) and radiographic analysis. The relative risk (RR) of dislocation was calculated. The average HHS significantly improved from a preoperative baseline to the last follow-up at 82.1 months (28 mm) and 44.3 months (36 mm). No statistically significant differences were revealed between the two groups for HHS results and complications (p>0.05), but the difference in RR of dislocation within the first year between the two groups was 7.85 (95% CI: 1.34-46.03), p=0.046.Although dislocation is multifactorial in etiology, the two groups were homogenous for all principal contributing factors except the diameter of the femoral head. Therefore, the use of 36-mm heads can reduce the risk of dislocation following THA by a factor of 8 compared to conventional 28 mm heads.

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    • "This approach is considered to have less effect on gait since the abductor muscles are not dissected (Shaw 1991, Hedlundh et al. 1995), but it has been associated with an increased risk of dislocations, with risk of injury to the sciatic nerve. More recent studies have shown that use of larger femoral head sizes can markedly reduce the dislocation rate (Amlie et al. 2010, Bistolfi et al. 2011, Ho et al. 2012). "
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