Dislocation incidence and risk factors following direct anterior primary total hip arthroplasty: a consecutive, single-surgeon cohort

Abstract

BackgroundsDislocation is one of the debilitating complications of total hip arthroplasty. It is a common reason for revision surgery after THA, along with other complications such as infection and instability. This study determined the incidence and risk factors of dislocation after primary total hip arthroplasty using the direct anterior approach.MethodsRetrospective Data from patients who underwent primary THA from 2013 to 2020 was analyzed. Anteversion and inclination angles were extracted from their imaging studies, and demographic data were also recorded from their medical records. Data were analyzed using SPSS version 26.ResultsOne thousand two hundred four cases of THA were reviewed in our study. 31 (2.57) dislocations happened after a minimum follow-up of five years. Our study showed that DDH diagnosis as the underlying condition, using Wagner Cone and Wagner SL stem, cup size smaller than 52, head size smaller than 34, anteversion and inclination angle outside the Lewinnek safe zone can be risk factors for dislocation. Primary OA and Fitmore stem acted as protective factors for dislocation.ConclusionIn the DA approach, the underlying disease, properties of the prosthesis used such as cup and head size, stem type, and anteversion and inclination angles can be the potential risk factors for dislocation.Level of evidenceIII