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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 3, 321-326.
doi: 10.1302/0301-620X.91B3.21274  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Outcome of treatment for dislocation after primary total hip replacement

R. S. Kotwal, MBBS, MS(Orth), IMRCS, Clinical Knee Fellow1; M. Ganapathi, FRCS(Orth), Consultant Orthopaedic Surgeon2; A. John, FRCS(Orth), Consultant Orthopaedic Surgeon1; M. Maheson, FRCSEng, FRCSEd, FRCS(Orth), Consultant Orthopaedic Surgeon1; and S. A. Jones, MRCS, MSc, FRCS(Ortho), Consultant Orthopaedic Surgeon1

1 Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff CF14 4XW, UK.
2 Department of Orthopaedics, Ysbyty Gwynedd, Bangor LL57 2PW, UK.

Correspondence should be sent to Mr R. S. Kotwal; e-mail: rahlktwl{at}aol.com

We have studied the natural history of a first episode of dislocation after primary total hip replacement (THR) to clarify the incidence of recurrent dislocation, the need for subsequent revision and the quality of life of these patients.

Over a six-year period, 99 patients (101 hips) presented with a first dislocation of a primary THR. A total of 61 hips (60.4%) had dislocated more than once. After a minimum follow-up of one year, seven patients had died. Of the remaining 94 hips (92 patients), 47 underwent a revision for instability and one awaits operation (51% in total). Of these, seven re-dislocated and four needed further surgery. The quality of life of the patients was studied using the Oxford Hip Score and the EuroQol-5 Dimension (EQ-5D) questionnaire. A control group of patients who had not dislocated was also studied. At a mean follow-up of 4.5 years (1 to 20), the mean Oxford Hip Score was 26.7 (15 to 47) after one episode of dislocation, 27.2 (12 to 45) after recurrent dislocation, 34.5 (12 to 54) after successful revision surgery, 42 (29 to 55) after failed revision surgery and 17.4 (12 to 32) in the control group. The EuroQol-5 dimension questionnaire revealed more health problems in patients undergoing revision surgery.




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S. A. Sexton, W. L. Walter, M. P. Jackson, R. De Steiger, and T. Stanford
Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement
J Bone Joint Surg Br, November 1, 2009; 91-B(11): 1448 - 1453.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General