title: Posterior soft tissue repair in total hip arthroplasty: a randomized controlled trial.
abstract: Posterior soft tissue repair is a well-known procedure in total hip arthroplasty (THA). Many reports have shown the advantage of posterior soft tissue repair in reducing the dislocation rate; however, we were unable to find any randomized trials in the literature. This article describes a randomized trial performed to investigate the effect of posterior soft tissue repair on the dislocation rate after 298 THAs in 291 patients. Preoperatively, patients were randomized into 2 groups: posterior soft tissue repair after insertion of the components, or no posterior soft tissue repair. One year postoperatively, 12 patients had died and 10 were lost to follow-up, leaving 276 THAs in 265 patients for analysis. A posterior soft tissue repair had been performed in 134 and no repair in 141 THA. One year postoperatively, 3 dislocations (2%) had occurred in the repaired group and 7 in the unrepaired group (5%); the difference was not significant (P=.3). There were 2 sciatic nerve palsies in the repaired group, 1 of which was directly related to the posterior soft tissue repair.In this randomized, controlled trial of 276 THAs followed for 1 year, there was a tendency for a lower dislocation rate, although not statistically significant, when a posterior repair was performed. If reattaching the posterior tendons, it should be performed with caution with respect to the sciatic nerve.
authors.affiliation: Department of Orthopedics, Kaunas Medical University, Kaunas, Lithuania. sarunas.tarasevicius@med.lu.se
authors.forename: Sarunas
authors.initials: S
authors.lastname: Tarasevicius
authors.forename: Otto
authors.initials: O
authors.lastname: Robertsson
authors.forename: Hans
authors.initials: H
authors.lastname: Wingstrand
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D015897:Comorbidity; D003238:Connective Tissue / Q000601:surgery*; D005260:Female; D006617:Hip Dislocation / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors