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Does surgical approach affect total hip arthroplasty dislocation rates?
Journal article   Peer reviewed

Does surgical approach affect total hip arthroplasty dislocation rates?

Michael S Kwon, Michael Kuskowski, Kevin J Mulhall, William Macaulay, Thomas E Brown and Khaled J Saleh
Clinical orthopaedics and related research, v 447(447)
01 Jun 2006
PMID: 16741471

Abstract

Abridged Index Medicus
Dislocation is a common complication of total hip arthroplasty, but exact effect of surgical approach on dislocation rates remains unclear. Because little randomized prospective data exist in this context, we performed a meta-analysis comparing dislocation rates using the posterior approach with and without soft tissue repair. A systematic literature review resulted in five studies which directly compared the posterior approach with and without soft tissue repair. The dislocation rates with and without repair were 0.49% and 4.46%, respectively. The relative risk for dislocation was determined using a fixed effects model with chi square test for interstudy heterogeneity. The posterior approach without soft tissue repair was found to have an 8.21 times greater relative risk of dislocation than with soft tissue repair (95% confidence interval, 4.05-16.67). A separate systematic review of 11 studies revealed comparable dislocation rates associated with the anterolateral, direct lateral, and posterior approaches with soft tissue repair (0.70%, 0.43%, and 1.01%, respectively). These data demonstrate that adequate soft tissue repair greatly reduces the relative risk of dislocation using the posterior approach, and that the dislocation rates for the three most prevalent approaches are similar. Further prospective randomized trials examining dislocation rates and other clinical parameters are needed.

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Surgery
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