DISLOCATIONS AFTER TOTAL HIP ARTHROPLASTY THROUGH A POSTERIOR APPROACH

Abstract

Purpose: The patients who had early postoperative dislocations following total hip arthroplasties were evaluated.
Patients and methods: Between 1994 and 1999 83 total hip arthroplasties were performed using a posterior approach. Eight of them had early postoperative dislocation. Three of these 8 patients were men and five were women. The mean age was 52 years (range, 33 to 63 years). The size of the femoral head was 28 mm in all patients. The indication for the total hip replacement was primary osteoarthrosis in 4 patients, dysplasia arthrosis in 1 patient, and neglected femoral neck fracture in 1 patient. The characteristics of this complications were studied. Results were evaluated according to modified Merle D’Aubigne and Postel criteria.
Results: Dislocations occurred between 2 to 22 days after surgery. All dislocations were posterior dislocation. In one patient, there was an obvious malposition (retroversion) of the socket of the endoprosthesis. This patient was re-operated for revision of the prosthetic socket. In one patient after closed reduction prosthetic infection was developed one year later, and resection of the prosthesis was performed. Closed reductions were successfully performed in the other 6 patients and no complication was developed in the follow-up visits. An average follow up of the patients was 3 years (range, 2 to 4 years). When modified Postel-Merle d’Aubigne criteria were use, an average score was 5,4 points for the patients with the complication, and 4,75 points for patients with no complication, which were not significantly different.
Conclusion: In conclusion, if there is not an operative failure such as malposition of the components early postoperative dislocation following total hip arthroplasty is a treatable complication. Required treatment would be bed rest and immobilisation.