The early dislocation rate in primary total hip arthroplasty following the posterior approach with posterior soft-tissue repair

Although a posterior approach is frequently used for total hip arthroplasties (THAs), some reports have associated this approach with higher dislocation rates than anterior or lateral approaches. To deter dislocations following primary THAs using the posterior approach, the senior author repairs the posterior capsule and the short external rotators to the greater trochanter with nonabsorbable suture. We retrospectively reviewed the occurrence of dislocations among 945 primary THAs performed with this technique at a mean 6.4-year follow-up (range, 2.0-9.3 years). The average patient age was 62.3 years (range, 36-86 years). Eight patients (0.85%) dislocated. Of these, 3 dislocated within the first postoperative year and were treated without surgery; 3 required revision surgery and placement of a constrained liner; and 2 dislocated after trauma and were treated without surgery. With the correct orientation of components and an enhanced soft-tissue repair, the posterior surgical approach can result in an extremely low dislocation rate.