Risk Factors for Dislocation after Primary Total Hip Arthroplasty with the Transtrochanteric Approach

Kyu-Tae Hwang; Young-Ho Kim; Yee-Suk Kim; Hyun-Jong Bong; Il-Yong Choi

doi:10.5371/jkhs.2010.22.1.52

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Hwang, Kim, Kim, Bong, and Choi: Risk Factors for Dislocation after Primary Total Hip Arthroplasty with the Transtrochanteric Approach

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2010; 22(1): 52-57.

Published online: 31 March 2010

DOI: https://doi.org/10.5371/jkhs.2010.22.1.52

Risk Factors for Dislocation after Primary Total Hip Arthroplasty with the Transtrochanteric Approach

Kyu-Tae Hwang, MD, Young-Ho Kim, MD, Yee-Suk Kim, MD, Hyun-Jong Bong, MD, Il-Yong Choi, MD

Department of Orthopedic Surgery, College of Medicine, Hanyang University, Seoul, Korea.

Address reprint request to Young-Ho Kim, MD. Department of Orthopaedic Surgery, Hanyang University Guri Hospital, 249-1 Gyomoon-dong, Guri-Si, Gyunggi-do 471-701, Korea. TEL: +82-31-560-2312, FAX: +82-31-557-8781, kimyh1@hanyang.ac.kr

Received 27 July 2009 Revised 20 October 2009 Accepted 30 November 2009

Abstract

Purpose

We wanted to evaluate the risk factors that predispose a patient to dislocation after undergoing primary total hip arthroplasty with the transtrochanteric approach.

Materials and Methods

Between July 1995 and May 2007, 593 consecutive total hip arthroplasties using the trantrochanteric approach were performed. A matched comparative study was performed for the dislocated group(18 hips) and the non-dislocated control group(18 hips). The patient-related factors and mechanical factors were retrospectively reviewed to evaluate the risk factors for dislocation.

Results

Dislocation occurred in 18 hips(3.04%). The mean age was 57.1 years in the dislocated group and 55.2 years for all of the patients (p>0.05). Statistical analyses of the BMI, inclination and anteversion of the cup, lowering of the hip center, a leg length discrepancy, the size of the femoral head and nonunion of the greater trochanter revealed no significant differences between the two groups. Nonunion of the greater trochanter was observed in 16 hips(2.84%). The risk of dislocation was 8.5 times higher in the patients with excessive alcohol intake (p<0.05). The combination of more than 3 risk factors significantly affected the incidence of dislocation after total hip arthroplasty (p<0.05).

Conclusion

After primary total hip arthroplasty with the transtrochanteric approach, in the cohort of this study, excessive alcohol intake was the main risk factor for dislocation and a combination of risk factors contributed to dislocation.

Keywords: Hip dislocation, Total hip arthroplasty, Risk factor, Transtrochanteric approach

Figures and Tables

Fig. 1

(A) Inclination of the cup is measured as the angle between the plane through the opening of the cup and the horizontal plane. (B) Anteversion of the cup is defined as the angle formed by the intersection of a line drawn across the face of the acetabulum and a line perpendicular to the horizontal plane.

Table 1

Characteristics of Patients

(^*Avascular Necrosis, ^†Rheumatoid Arthritis, ^‡Osteoarthritis)

Table 2

Risk Factors

(^*Body Mass Index, ^†Greater Trochanter)

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