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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2007 February;58(1):23-6
Early dislocation after bipolar hemiarthroplasty of the hip: a comparison of the dislocation rate after posterior and lateral approaches to the hip
Iversen B. F. 1, Levi N. 2
1 Department of Orthopaedic Surgery Aker University Hospital Oslo, Norway
2 Department of Orthopaedic Surgery Sunderby Hospital Lulea, Sweden
Aim. The reported incidence of dislocation of a hip hemiarthroplasty is from less than 1% to 10%. The associated mortality is at least 50% and recurrent dislocation has an even higher mortality. A suggested advantage of the bipolar design is improved stability of the prosthesis and resistance to dislocation. Other factors that may influence the incidence of dislocation include the surgical approach. However, there is no consensus on the best approach. The aim of this study was, therefore, to assess the effect of the lateral and posterior surgical approach on the dislocation rate after bipolar hemiarthroplasty of the hip.
Methods. During a 7-year period a total of 431 bipolar hemiarthroplasty operations of the hip were performed. Midway through the reviewed series the surgical approach was changed from a posterior approach according to Moore to a transgluteal lateral approach according to Hardinge. There were 331 women and 100 men. The average age of the women was 80 years and the average age of the men was 78 years.
Results. A total of 11 bipolar hemiarthroplasties (1 in men and 10 in women) dislocated. The 3-months dislocation rate was 1/100= 1% for men and 10/331= 3% for women. The overall 3-months dislocation rate was, therefore, 11/431= 2.6%. There was no significant difference between the posterior and lateral approach.
Conclusion. The dislocation rate in this series is similar to that in recent reports and was independent of the choice of surgical approach.