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Combined Anteversion Threshold to Avoid Anterior Dislocation in Primary Total Hip Arthroplasty Performed Through the Direct Anterior Approach.
Dimitriou, Dimitris; Zindel, Christoph; Winkler, Elin; Cornaz, Frédéric; Mazel, Peter; Zingg, Patrick O.
Afiliación
  • Dimitriou D; Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland.
  • Zindel C; Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland.
  • Winkler E; Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland.
  • Cornaz F; Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland.
  • Mazel P; Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland.
  • Zingg PO; Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland.
J Arthroplasty ; 39(1): 145-150, 2024 01.
Article en En | MEDLINE | ID: mdl-37331442
ABSTRACT

BACKGROUND:

Component malposition in total hip arthroplasty (THA) can lead to dislocation, early implant failure, and revision surgery. As the surgical approach might affect the targeted combined anteversion (CA) of THA components, the present study aimed to evaluate the optimal CA threshold to avoid anterior dislocation in primary THA performed through a direct anterior approach (DAA).

METHODS:

A total of 1,176 THAs in 1,147 consecutive patients (men 593, women 554) who had an average age of 63 years (range, 24 to 91) and a mean body mass index of 29 (range, 15 to 48) were identified. Medical records were reviewed for dislocation, whereas postoperative radiographs were assessed to measure the acetabular inclination and CA using a previously validated radiographic method.

RESULTS:

An anterior dislocation occurred in 19 patients at an average of 40 days postoperatively. The average CA in patients who did and did not have a dislocation was 66 ± 8° and 45 ± 11°, respectively (P < .001). In 5 of 19 of the patients, a THA was performed for secondary osteoarthritis and 17 of 19 had a 28-mm femoral head. A CA ≥ 60° yielded a sensitivity of 93% and specificity of 90% for predicting an anterior dislocation in the present cohort. A CA ≥ 60° was associated with a significantly higher risk of anterior dislocation (odds ratio = 75.6; P < .001) compared to patients who had a CA<60 points.

CONCLUSION:

The optimal CA to avoid anterior dislocations in THA performed through the DAA should be less than 60°. LEVEL OF EVIDENCE Cross-sectional study, Level III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Luxaciones Articulares / Luxación de la Cadera / Prótesis de Cadera Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos
Texto completo
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Imprimir
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Luxaciones Articulares / Luxación de la Cadera / Prótesis de Cadera Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos