title: Dislocation rates following primary total hip arthroplasty have plateaued in the Medicare population.
abstract: The purpose of this study was to determine if the use of larger femoral head diameters, in combination with recent practice including enhanced soft tissue choices and various operative exposure choices has led to any further decline in dislocation rates. 51,901 patients undergoing primary THA were identified from 5% Medicare Part B (physician/carrier) claims between January 1, 1997 and December 31, 2011. Dislocation rate at 6 months following THA was 2.84% over the study period (1997-2011). From 2005 to 2011, dislocation rates following primary THA have plateaued in the United States at approximately 2%. This suggests that the full benefits using large femoral head sizes are now realized. For further improvement in dislocation rates, a greater emphasis will be required on patient selection, surgical technique and component alignment.
authors.affiliation: Department of Orthopedics, KentuckyOne Health, University of Louisville, Louisville, Kentucky.
authors.forename: Akshay
authors.initials: A
authors.lastname: Goel
authors.affiliation: Exponent Inc., Menlo Park, California.
authors.forename: Edmund C
authors.initials: EC
authors.lastname: Lau
authors.affiliation: Exponent Inc., Philadelphia, Pennsylvania.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Ong
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Berry
authors.affiliation: Department of Orthopedics, KentuckyOne Health, University of Louisville, Louisville, Kentucky.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Malkani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005270:Femur Head / Q000601:surgery; D006617:Hip Dislocation / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D014481:United States
keywords: Medicare database; complication total hip; dislocation; large head size; primary total hip arthroplasty