Cadera/Hip/Hüfte/Hanche: Más cabezonas pero más estables

Dislocation Rates Following Primary Total Hip Arthroplasty Have Plateaued in the Medicare Population
Akshay Goel, Edmund Lau, Kevin L. Ong, Daniel J. Berry, Arthur L. Malkani
The Journal of Arthroplasty
Accepted: November 18, 2014;
DOI: http://dx.doi.org/10.1016/j.arth.2014.11.012

Abstract

Dislocation remains one of the most frequent complications following total hip replacement. Numerous risk factors predisposing patients to dislocation have been identified. Larger diameter femoral heads (32 mm or larger) came into common use in the mid 2000’s have been shown to improve hip stability. The purpose of this study was to determine if the use of larger femoral head diameters, in combination with recent practice including enhanced soft tissue choices and various operative exposure choices has led to any further decline in dislocation rates following primary total hip arthroplasty. The study included 51,901 patients undergoing primary THA identified from 5% Medicare Part B (physician/carrier) claims between January 1, 1997 and December 31, 2011. Dislocation rate at 6 months following THA was 2.84% over the study period (1997–2011). From 2005–2011, dislocation rates following primary THA have plateaued in the United States at approximately 2%. This suggests that the full benefits using large femoral head sizes now realized. For further improvement in dislocation rates, a greater emphasis will be required on patient selection, surgical technique and component alignment.