title: The functional and financial impact of isolated and recurrent dislocation after total hip arthroplasty.
abstract: The aims of this study were to determine the functional impact and financial burden of isolated and recurrent dislocation after total hip arthroplasty (THA). Our secondary goal was to determine whether there was a difference between patients who were treated non-operatively and those who were treated operatively. We retrospectively reviewed 71 patients who had suffered dislocation of a primary THA. Their mean age was 67 years (41 to 92) and the mean follow-up was 3.8 years (2.1 to 8.2). Because patients with recurrent dislocation were three times more likely to undergo operative treatment (p < 0.0001), they ultimately had a significantly higher mean Harris Hip Score (HHS) (p = 0.0001), lower mean Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores (p = 0.001) and a higher mean SF-12 score (p < 0.0001) than patients with a single dislocation. Likewise, those who underwent operative treatment had a higher mean HHS (p < 0.0001), lower mean WOMAC score (p < 0.0001) and a higher mean SF-12 score (p < 0.0001) than those who were treated non-operatively. Recurrent dislocation and operative treatment increased costs by 300% (£11 456; p < 0.0001) and 40% (£5217; p < 0.0001), respectively. The operative treatment of recurrent dislocation results in significantly better function than non-operative management. Moreover, the increase in costs for operative treatment is modest compared with that of non-operative measures.
authors.affiliation: Mayo Clinic, Mayo Clinic, 200 First St. SW, Rochester, Minnesota, 55905, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Abdel
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, New York, 10021, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Cross
authors.affiliation: University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
authors.forename: A T
authors.initials: AT
authors.lastname: Yasen
authors.affiliation: University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000191:economics* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics* / Q000628:therapy*; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies
keywords: Hip instability; Dislocation; Primary total hip arthroplasty (THA); Financial and economic costs; Patient reported outcome measures (PROMs)