JBJS | Revision Total Hip Arthroplasty for Instability: Surgical Techniques and Principles

The Journal of Bone & Joint Surgery, Volume 90, Issue 5

Selected Instructional Course Lecture | May 01, 2008

Revision Total Hip Arthroplasty for Instability: Surgical Techniques and Principles

Javad Parvizi, MD, FRCS¹; Elizabeth Picinic, BS¹; Peter F. Sharkey, MD¹

¹ Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107. E-mail address for J. Parvizi: parvj@aol.com

The Journal of Bone & Joint Surgery. 2008; 90:1134-1142

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Look for this and other related articles in Instructional Course Lectures, Volume 58, which will be published by the American Academy of Orthopaedic Surgeons in February 2009:"Perioperative Management of Total Hip Arthroplasty: Blood Preservation in Total Joint Arthroplasty," by Charles R. Clark, MDTotal hip arthroplasty is one of the most successful orthopaedic procedures and is highly effective in relieving pain and improving function^1-3. Unfortunately, some patients are faced with complications, with dislocation being one of the most common^4-8. Dislocation occurs after 0.3% to 10% of primary total hip arthroplasties and after up to 28% of revision total hip arthroplasties^4-26. The risk of dislocation is influenced by the surgical approach, the underlying diagnosis, the surgical technique, the lifetime of the prosthesis, and the patient's compliance with restrictions^6,7,25,27-31. An improved understanding of the etiology of dislocation and refinements in surgical techniques have led to a decrease in the rate of dislocation over time^{1,5,6,8,10,19,20,28,32-35}. Although most dislocations after total hip arthroplasty are single episodes that can be managed nonoperatively^8,26,28,35, some patients require surgical intervention to address recurrent dislocation^7,35.

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Topics

dislocations ; arthroplasty ; hip replacement arthroplasty ; head of femur

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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