Revision surgery for recurrent dislocation following total hip arthroplasty

Abstract

Abstract Background There are many therapeutic options for dislocation following total hip arthroplasty (THA). The aim of this study was to evaluate the results of revision surgery for dislocated hips. Methods Between November 2001 and December 2020, 71 consecutive revision hip surgeries were performed at our institution for recurrent dislocation following THA. We conducted a retrospective study of all 65 patients (71 hips), who were followed for a mean of 4.7 years (range, 1–14). The cohort included 48 women and 17 men, with a mean age of 71 years (range, 34–92). The mean number of previous surgeries was 1.6 (range, 1–5). Revision hip surgeries for recurrent dislocation following THA were classified as follows: open reduction and internal fixation, 2 hips; only head change or only liner change, 6 hips; only cup change with head size up, 14 hips; only stem change, 7 hips; cup and stem change, 24 hips; and conversion to constrained cup, 18 hips. Prosthesis survival was analyzed using the Kaplan-Meier method, with repeat revision surgery for re-dislocation or implant failure considered the endpoint. Cox proportional hazards model was performed for risk factors of re-revision surgery. Results Re-dislocation occurred in 5 hips (7.0%) and implant failure occurred in 1 hip (1.4%). The 10-year survival rate was 81.1% (95% confidence interval, 65.5–96.8). A risk factor for re-revision surgery due to re-dislocation was “positional” according to Dorr’s classification. Conclusion It is important to assess the cause of the dislocation to determine the most appropriate procedure.