Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Instability After Total Hip Arthroplasty
CASE STUDY
A 78-year-old woman underwent right total hip arthroplasty using a posterolateral approach 4 years before she was referred to our center. During that time, she sustained two posterior hip dislocations that were treated successfully by closed reduction. She also reported sensations of the hip clicking, for which she had to “turn” it back into place. Infection was ruled out by negative serology results. Radiographs showed well-fixed components without obvious malposition ( Fig. 68.1 ). Computed tomography showed a slightly decreased degree of acetabular anteversion.
Chapter Preview
Chapter Synopsis
Instability after total hip arthroplasty (THA) is a serious complication that results in patient dissatisfaction and frequently necessitates revision surgery. For approximately 60% of patients, closed reduction can successfully treat the first dislocation if it occurs soon after the THA. Patients who experience multiple dislocations frequently need revision surgery. Determination of the cause of instability is essential for a successful revision.
Clinical/Surgical Pearls
-
In the setting of well-fixed and well-positioned components, use of modular components can ease the adjustment of soft tissue tensioning.
-
If component positioning or the clinical track record is poor, revision of the components should be considered even when they are well fixed.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here