We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Multivariate analysis of risk factors for re-dislocation after revision for dislocation after total hip arthroplasty.
- Authors
Herman, Amir; Masri, Bassam A; Duncan, Clive P; Greidanus, Nelson V; Garbuz, Donald S
- Abstract
Background: The treatment for recurrent dislocation of a total hip arthroplasty is surgical using varied techniques and technologies to reduce the chances of re-dislocation and re-revision. The goal of this study is to compare operative techniques to reduce re-dislocation and re-revision in revision hip arthroplasty due to recurrent dislocations. Methods: A retrospective study of revision hip arthroplasties done due to recurrent dislocation prior to 01 January 2014. Electronic physician and provincial health records were used to collect patients' initial and follow-up data. Treatment failure was defined as either aseptic re-revision or re-dislocation without revision. Time to event was considered as the re-revision date or the date of second dislocation when the latter endpoint was used. Results: Of 379 operations, 88 (23.2%) had aseptic repeat revision or recurrent dislocation. Of these: 66 (75.0%) due to dislocation with re-revision; 10 (11.4%) due to dislocation with no re-revision surgery; 5 (5.7%) due to aseptic loosening of components; 3 (3.4%) due to osteolysis; 3 (3.4%) due to pseudotumour; and 1 (1.1%) due to periprosthetic fracture. The following factors increase risk of failure: the use of augmented-liners (lipped, oblique and high-offset liners; HR = 1.68, 95% CI, 1.05–2.69), periprosthetic femur fracture (HR = 2.80, 95% CI, 1.39–8.21) and pelvic discontinuity (HR = 3.69, 95% CI, 1.66–8.21). Femur head sizes 36–40 mm are protective (HR = 0.54, 95% CI, 0.31–0.86). In abductor dysfunction the use of focal constrained liners decreases the risk of failure (HR = 0.13, 95% CI, 0.018–0.973). Conclusions: Larger head sizes and focal constrained liners (abductors dysfunction) should be used and fully constrained liners and augmented-liners should be avoided in a revision hip arthroplasty due to recurrent dislocations.
- Subjects
BONE resorption; CONFIDENCE intervals; FEMUR injuries; BONE fractures; HIP joint dislocation; MEDICAL records; MULTIVARIATE analysis; PROSTHETICS; COMPLICATIONS of prosthesis; REOPERATION; RISK assessment; TIME; TOTAL hip replacement; DISEASE relapse; TREATMENT effectiveness; RETROSPECTIVE studies; ELECTRONIC health records; ABDUCTOR pollicis longus muscle; ACQUISITION of data methodology; ODDS ratio; PERIPROSTHETIC fractures; DISEASE complications
- Publication
Hip International, 2020, Vol 30, Issue 1, p93
- ISSN
1120-7000
- Publication type
Article
- DOI
10.1177/1120700019831628