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The result of transmuscular versus transosseous repair of the posterior capsule on early dislocations in primary hip arthroplasty.

AbstractPURPOSE:
Dislocation is a concerning complication of the posterolateral approach for total hip arthroplasty (THA). Use of a larger size femoral head and a correct repair of the posterior structures can reduce the risk on dislocation of the hip prosthesis. In this study we investigated if there was a difference in dislocation rate between transmuscular and transosseous repair of the posterior soft tissues with use of 36 mm heads.
METHODS:
A power analysis showed that with a standardised effect size of 0.3 and p-value of 0.05, each group should include at least 174 patients. A total of 465 consecutive primary THAs with a posterolateral approach were performed in patients with primary osteoarthritis by 3 orthopaedic surgeons. There were 246 patients operated using transmuscular repair, the other 219 by using transosseous repair. All patients were given the same prostheses.
RESULTS:
Dislocation rate was 1.7% in all patients with at least 1 year follow-up. No significant difference was found in dislocation between both reconstruction techniques. Clinical outcome scores were comparable between the groups.
CONCLUSIONS:
Transosseous and transmuscular repair were equally effective techniques in closing the posterior soft tissues after THA through the posterolateral approach, without difference in dislocation rate or complication rate.
AuthorsElsa A Spaans, Anne J Spaans, Joost A A M van den Hout, Stefan B T Bolder
JournalHip international : the journal of clinical and experimental research on hip pathology and therapy (Hip Int) 2015 Nov-Dec Vol. 25 Issue 6 Pg. 537-42 ISSN: 1724-6067 [Electronic] United States
PMID26351119 (Publication Type: Journal Article)
Topics
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip (methods)
  • Female
  • Follow-Up Studies
  • Hip Dislocation (diagnosis, etiology, surgery)
  • Hip Prosthesis
  • Humans
  • Joint Capsule (surgery)
  • Male
  • Middle Aged
  • Osteoarthritis, Hip (diagnosis, etiology, surgery)
  • Prosthesis Failure
  • Reoperation
  • Treatment Outcome

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