| Popis: |
Aims: The use of the direct anterior approach (DAA) for total hip arthroplasty (THA) has increased but occasions for dislocations and treatment, course and the outcome after dislocation are rarely evaluated. Therefore, in this study we aim to give an overview of dislocations after THA by DAA. Material and methods: We retrospectively analyzed all patients who had THA by DAA for osteoarthritis (OA) between 2014 and 2019 with 1-year follow-up in our hospital. We studied occasions and risk factors and compared outcome of hip function at 1-year follow-up by use of the Oxford Hip Score (OHS) for patients with and without dislocation. Results: A total of 2933 patients were included. Dislocation rate was 0.7% (n=21). 15 patients had a single dislocation, 6 patients had a second dislocation (29%) of which 1 had a third dislocation. Of the dislocations, 81% (17/21) were in the anterior direction and 86% (18/21) were in the first postoperative month. Most dislocations took place when patients were sitting, sitting and turning or getting up from a chair (n=9). Patients with a dislocation had a higher Body Mass Index than those without a dislocation (29.6 vs 27.0 kg/m2, 95% CI -4.4 to -0.7, p=0.007). Five patients had revision surgery (24%). OHS at 1y-FU (42 vs 44, 95% CI -1.2 to 5.2, p=0.25) and mean change (16 vs 18, 96% CI -2.1 to 7.3, p=0.22) did not significantly differ between patients with or without dislocation. Conclusion: Dislocation rate after THA by DAA is low and causes vary. Outcomes after dislocation can still be satisfying, as Oxford Hip Scores at 1-year follow-up were comparable for those with and without dislocation, especially for those with conservative treatment. These findings may support shared decision in treatment strategies and information for patients with a dislocation. |
