Evaluation of the Rate of Post-operative Dislocation in Patients with Ipsilateral Valgus Knee Deformity After Primary Total Hip Arthroplasty

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2022 Mar 20

PMID 35306569

Authors

Hao Li

Jin-Wei Xie

Zi-Chuan Ding

Ming-Cheng Yuan

Ya-Hao Lai

Zong-Ke Zhou

Affiliations

Soon will be listed here.

Abstract

Purpose: There is scant literature on the evaluation of dislocation after total hip arthroplasty (THA) in patients with ipsilateral valgus knee deformity. This study aimed to investigate the post-operative dislocation rate in patients with valgus knee deformity who underwent ipsilateral THA and identify whether ipsilateral valgus knee deformity increases the dislocation rate after THA.

Methods: We retrospectively reviewed patients with valgus knee deformity who underwent ipsilateral THA in our institution from January 2016 to December 2018. Each hip with ipsilateral valgus knee deformity was matched with a hip without valgus knee deformity according to sex, affected side, and date of surgery. The primary outcome was the dislocation rate after THA. Univariate analyses were initially used to compare data between the dislocation group and the non-dislocation group. Independent risk factors for dislocation were determined using multivariate logistic regression.

Results: There were 257 THAs with ipsilateral valgus knee deformity (valgus knee group) and 257 THAs without valgus knee deformity (control group). The valgus knee group showed a significantly higher dislocation rate than the control group (9.7% versus 1.6%, p < 0.001). Older age (p = 0.020) and malposition of the acetabular cup (p = 0.048) were independent risk factors of post-operative dislocation.

Conclusion: Patients with valgus knee deformity have a higher risk of dislocation after ipsilateral THA. If ipsilateral THA and total knee arthroplasty must be performed successively, total knee arthroplasty may have an earlier priority than THA.

References

Gwam C, Mistry J, Mohamed N, Thomas M, Bigart K, Mont M . Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty. 2017; 32(7):2088-2092. DOI: 10.1016/j.arth.2017.02.046. View

Ding Z, Xu B, Liang Z, Wang H, Luo Z, Zhou Z . Limited Influence of Comorbidities on Length of Stay after Total Hip Arthroplasty: Experience of Enhanced Recovery after Surgery. Orthop Surg. 2019; 12(1):153-161. PMC: 7031546. DOI: 10.1111/os.12600. View

Ding Z, Zeng W, Mou P, Liang Z, Wang D, Zhou Z . Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip. Orthop Surg. 2020; 12(2):589-600. PMC: 7189031. DOI: 10.1111/os.12665. View

Rowan F, Benjamin B, Pietrak J, Haddad F . Prevention of Dislocation After Total Hip Arthroplasty. J Arthroplasty. 2018; 33(5):1316-1324. DOI: 10.1016/j.arth.2018.01.047. View

Malkani A, Ong K, Lau E, Kurtz S, Justice B, Manley M . Early- and late-term dislocation risk after primary hip arthroplasty in the Medicare population. J Arthroplasty. 2010; 25(6 Suppl):21-5. DOI: 10.1016/j.arth.2010.04.014. View

Bozic K, Kamath A, Ong K, Lau E, Kurtz S, Chan V . Comparative Epidemiology of Revision Arthroplasty: Failed THA Poses Greater Clinical and Economic Burdens Than Failed TKA. Clin Orthop Relat Res. 2014; 473(6):2131-8. PMC: 4418985. DOI: 10.1007/s11999-014-4078-8. View

Bozic K, Kurtz S, Lau E, Ong K, Vail T, Berry D . The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009; 91(1):128-33. DOI: 10.2106/JBJS.H.00155. View

Kotwal R, Ganapathi M, John A, Maheson M, Jones S . Outcome of treatment for dislocation after primary total hip replacement. J Bone Joint Surg Br. 2009; 91(3):321-6. DOI: 10.1302/0301-620X.91B3.21274. View

Abdel M, Cross M, Yasen A, Haddad F . The functional and financial impact of isolated and recurrent dislocation after total hip arthroplasty. Bone Joint J. 2015; 97-B(8):1046-9. DOI: 10.1302/0301-620X.97B8.34952. View

10.

Sanchez-Sotelo J, Haidukewych G, Boberg C . Hospital cost of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am. 2006; 88(2):290-4. DOI: 10.2106/JBJS.D.02799. View

11.

Buckland A, Puvanesarajah V, Vigdorchik J, Schwarzkopf R, Jain A, Klineberg E . Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J. 2017; 99-B(5):585-591. DOI: 10.1302/0301-620X.99B5.BJJ-2016-0657.R1. View

12.

Gausden E, Parhar H, Popper J, Sculco P, Rush B . Risk Factors for Early Dislocation Following Primary Elective Total Hip Arthroplasty. J Arthroplasty. 2018; 33(5):1567-1571.e2. DOI: 10.1016/j.arth.2017.12.034. View

13.

Jamsen E, Puolakka T, Peltola M, Eskelinen A, Lehto M . Surgical outcomes of primary hip and knee replacements in patients with Parkinson's disease: a nationwide registry-based case-controlled study. Bone Joint J. 2014; 96-B(4):486-91. DOI: 10.1302/0301-620X.96B4.33422. View

14.

Lange J, Haas S . Correcting severe valgus deformity: taking out the knock. Bone Joint J. 2017; 99-B(1 Supple A):60-64. DOI: 10.1302/0301-620X.99B1.BJJ-2016-0340.R1. View

15.

Kawaguchi K, Inui H, Taketomi S, Yamagami R, Takagi K, Kage T . Rotational kinematics differ between mild and severe valgus knees in total knee arthroplasty. Knee. 2020; 28:81-88. DOI: 10.1016/j.knee.2020.10.010. View

16.

Nikolopoulos D, Michos I, Safos G, Safos P . Current surgical strategies for total arthroplasty in valgus knee. World J Orthop. 2015; 6(6):469-82. PMC: 4501933. DOI: 10.5312/wjo.v6.i6.469. View

17.

Meding J, Faris P, Davis K . Bilateral Total Hip and Knee Arthroplasties: Average 10-Year Follow-Up. J Arthroplasty. 2017; 32(11):3328-3332. DOI: 10.1016/j.arth.2017.05.029. View

18.

Guo S, Zhou Y, Yang D, Yang X . Lower-limb valgus deformity associated with developmental hip dysplasia. Chin Med J (Engl). 2012; 125(22):3956-60. View

19.

Zhao H, Kang P, Xia Y, Shi X, Nie Y, Pei F . Comparison of Early Functional Recovery After Total Hip Arthroplasty Using a Direct Anterior or Posterolateral Approach: A Randomized Controlled Trial. J Arthroplasty. 2017; 32(11):3421-3428. DOI: 10.1016/j.arth.2017.05.056. View

20.

Harsten A, Kehlet H, Ljung P, Toksvig-Larsen S . Total intravenous general anaesthesia vs. spinal anaesthesia for total hip arthroplasty: a randomised, controlled trial. Acta Anaesthesiol Scand. 2014; 59(3):298-309. DOI: 10.1111/aas.12456. View