Trochanteric advancement for recurrent dislocation after total hip arthroplasty |
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| Authors: | S J Kaplan W H Thomas R Poss |
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| Affiliation: | 1. Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland;2. Department of Applied Physics, University of Eastern Finland, Kuopio, Finland;3. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland;4. Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland;5. Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland;6. Departments of Psychiatry, Kuopio University Hospital, Kuopio, Finland;7. Department of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland;8. Department of Psychiatry, North Karelia Central Hospital, Joensuu, Finland;9. Department of Psychiatry, SOSTERI, Savonlinna, Finland;10. Department of Psychiatry, SOTE, Iisalmi, Finland;11. Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland;12. Clinic of Child Psychiatry, University Hospital of Oulu, Oulu, Finland;13. Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland;1. Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands;2. Department of Orthopaedic Surgery and Traumatology, Haaglanden Medical Center, The Hague, the Netherlands;3. Department of Orthopaedic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands |
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| Abstract: | Twenty-one patients had trochanteric advancement after experiencing an average of 3.9 dislocations in a mean period of 46 weeks following total hip arthroplasty. Before trochanteric advancement was performed, component malposition and mechanical impingement were excluded as causes of dislocation. Radiographic measurements revealed that the trochanter was advanced an average of 16 +/- 7.7 mm (1 SD). Four patients, all with rheumatoid arthritis, had trochanteric migration greater than 1 cm. Seventeen of the 21 hips had no further dislocations following trochanteric advancement, with mean follow-up period of 2.7 years. Two patients dislocated because of extremes in hip position and had no further dislocations. Two patients dislocated who had trochanteric migration greater than 1 cm. Only one patients with a technically satisfactory trochanteric advancement continued to dislocate repeatedly. In patients without component malposition or obvious sources of impingement, trochanteric advancement is an effective and safe procedure for prevention of recurrent dislocations after total hip arthroplasty. |
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