Reduction in early dislocation rate with large-diameter femoral heads in primary total hip arthroplasty.
Large-diameter femoral heads, which may reduce dislocation, are used without extensive in vivo research. Two studies were done to determine relative dislocation rates. Study 1 compared dislocation rates in primary total hip arthroplasties (THAs) using 28- or 38-mm heads. Study 2 evaluated dislocation rates in large-diameter (38-56 mm) metal-on-metal heads. In study 1, 136 patients with 38-mm heads via posterior approach and 160 patients with 28-mm heads via Hardinge approach had an average of 52 months of follow-up (range, 32-106 months). In study 2, 469 patients had THA with large-diameter metal-on-metal heads, with an average of 36 months of follow-up (range, 24-46 months). Harris hip scores evaluated the clinical outcomes. Study 1 had no dislocations in the 38-mm group and had 4 dislocations (2.5%) in the 28-mm group (P = .12). Study 2 had 2 dislocations (0.4%). Dislocation rates in primary THA with 38-mm bearings via posterior approach are the same as 28-mm bearings via Hardinge approach. Metal-on-metal THA with 38 to 56 mm heads is also associated with low dislocation rates (0.4%) at short-term follow-up.
Peters
Christopher L
CL
University of Utah Department of Orthopaedics, Salt Lake City, Utah 84108, USA.
McPherson
Edward
E
Jackson
Jeffrey D
JD
Erickson
Jill A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000517:prevention & control*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design