CAUSES OF DISLOCATION OF TOTAL HIP ARTHROPLASTY

We reviewed radiographs and CT scans of 38 total hip arthroplasties which had dislocated (36 posteriorly; 2 anteriorly) and compared the alignment ofthe prosthetic components with those of 14 uncomplicated arthroplasties. No difference was found between the alignment of the prosthetic components in the two groups. In the seven patients who had reoperations, the cause of dislocation diagnosed by CT was confirmed in only two cases (one retroversion of the cup and one protruding osteophyte). Muscular imbalance rather than malposition of the components was the major factor determining dislocation. CT allows accurate measurement of cup and neck anteversion but contributes little to preoperative planning.

[1]  J. Charnley,et al.  Total hip replacement by low-friction arthroplasty. , 1970, Clinical orthopaedics and related research.

[2]  Müller Me.  Total hip prostheses. , 1970 .

[3]  D Resnick,et al.  Evaluation of acetabular anteversion following total hip arthroplasty: necessity of proper centring. , 1975, The British journal of radiology.

[4]  J. Lewis,et al.  Dislocations after total hip-replacement arthroplasties. , 1978, The Journal of bone and joint surgery. American volume.

[5]  H. Yuan,et al.  Computerized tomography in disorders of the hip. , 1978, The Journal of bone and joint surgery. American volume.

[6]  B. Ghelman.  Radiographic localization of the acetabular component of a hip prosthesis. , 1979, Radiology.

[7]  R. Poss,et al.  Dislocation in total hip arthroplasties. , 1980, Clinical orthopaedics and related research.

[8]  W H Harris,et al.  Advances in surgical technique for total hip replacement: without and with osteotomy of the greater trochanter. , 1980, Clinical orthopaedics and related research.

[9]  J. D. Visser,et al.  A method for calculating acetabular anteversion, femur anteversion and the instability index of the hip joint. , 1980, The Netherlands journal of surgery.

[10]  K E Marks,et al.  A ten-year follow-up of one hundred consecutive Müller curved-stem total hip-replacement arthroplasties. , 1982, The Journal of bone and joint surgery. American volume.

[11]  E. Barmeir,et al.  Computed tomography in the assessment and planning of complicated total hip replacement. , 1982, Acta Orthopaedica Scandinavica.

[12]  J P Conaty,et al.  Classification and treatment of dislocations of total hip arthroplasty. , 1983, Clinical orthopaedics and related research.

[13]  M. B. Coventry.  Late dislocations in patients with Charnley total hip arthroplasty. , 1985, The Journal of bone and joint surgery. American volume.

[14]  H. Uhthoff,et al.  Anteversion of the acetabular cup. Measurement of angle after total hip replacement. , 1986, The Journal of bone and joint surgery. British volume.

[15]  B F Morrey,et al.  Instability after total hip arthroplasty. , 1992, The Orthopedic clinics of North America.

[16]  S. Mian,et al.  Computed tomography measurement of acetabular cup anteversion and retroversion in total hip arthroplasty. , 1992, Clinical orthopaedics and related research.