Saturday, March 13, 2004
Repair of the posterior capsule decreased the incidence of dislocation in primary total hip arthroplasty (THA), accoarding to researchers for Poster Exhibit P025. Posterior capsule repair minimizes the patient's ability to internally rotate the hip and thereby helps prevent dislocation. The researchers advocate routine posterior capsule repair in patients undergoing THA using the posterolateral approach.
The researchers hoped to demonstrate the importance of reattachment of the posterior capsule to minimize dislocation following THA.
The same surgeon performed 216 consecutive primary THA, which were divided into two groups. In Group A, the posterior capsule was excised entirely, and in Group B, the posterior capsule was preserved and reattached to its origin under the greater trochanter. In Group A, there were 113 patients, with an average age of 62 years (range: 20 to 89 years). In Group B, there were 93 patients, with an average age of 63 years (range: 19 to 92 years).
The dislocation rate in Group A was 4.4 percent, which decreased to 1.1 percent in Group B. Four out of five patients in Group A who dislocated were females and became recurrent dislocators requiring revision surgery. In Group B, one patient dislocated three months following the primary procedure due to a fall and was treated successfully with closed reduction and did not require revision.
Researchers included Arthur L Malkani, MD; Brent Walz, MD; and Dale Baker, BA, all of Louisville, Ky.; and Omar N Osmani, MD, of Tempe, Ariz.
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