title: Achilles allograft reconstruction for recurrent dislocation in total hip arthroplasty.
abstract: Recurrent dislocation secondary to posterior soft tissue deficiency is a challenging complication of total hip arthroplasty. We describe the use of an Achilles allograft sling to improve hip stability. Eight patients treated with the sling were followed an average of 5 years. Seven patients had no recurrent instability and good postoperative range of motion. One graft failed in a patient with a neuropathic hip. Cadaveric biomechanical testing was also performed to investigate the stiffness and torque to failure of the sling in 6 specimens. Allograft slings can be used to improve hip stability. The technique is relatively easy to perform and does not limit postoperative range of motion. The graft decreases joint stiffness and has a greater torque to failure than the intact capsule.
authors.affiliation: San Francisco Orthopaedic Residency Program, San Francisco, California, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Van Warmerdam
authors.forename: William A
authors.initials: WA
authors.lastname: McGann
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Donnelly
authors.forename: John
authors.initials: J
authors.lastname: Kim
authors.forename: Richard B
authors.initials: RB
authors.lastname: Welch
mesh_terms: D000125:Achilles Tendon / Q000637:transplantation*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery*; D006621:Hip Joint / Q000502:physiology / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D055502:Secondary Prevention; D014184:Transplantation, Homologous; D016896:Treatment Outcome