Reduction in Early Dislocation Rate With Large-Diameter Femoral Heads in Primary Total Hip Arthroplasty

• Published in: The Journal of arthroplasty 2007-09, Vol.22 (6), p.140-144
• Main Authors: Peters, Christopher L., MD, McPherson, Edward, MD, Jackson, Jeffrey D., MD, Erickson, Jill A., PA-C
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; anterolateral approach; Arthroplasty, Replacement, Hip - instrumentation; dislocation; Female; Follow-Up Studies; Hip Dislocation - prevention & control; Hip Prosthesis; Humans; large-diameter femoral heads; Male; metal on metal; Middle Aged; Orthopedics; posterior approach; Postoperative Complications; Prospective Studies; Prosthesis Design; total hip arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2007.04.019

Abstract Large-diameter femoral heads, which may reduce dislocation, are used without extensive in vivo research. Two studies were done to determine relative dislocation rates. Study 1 compared dislocation rates in primary total hip arthroplasties (THAs) using 28- or 38-mm heads. Study 2 evaluated dislocation rates in large-diameter (38-56 mm) metal-on-metal heads. In study 1, 136 patients with 38-mm heads via posterior approach and 160 patients with 28-mm heads via Hardinge approach had an average of 52 months of follow-up (range, 32-106 months). In study 2, 469 patients had THA with large-diameter metal-on-metal heads, with an average of 36 months of follow-up (range, 24-46 months). Harris hip scores evaluated the clinical outcomes. Study 1 had no dislocations in the 38-mm group and had 4 dislocations (2.5%) in the 28-mm group ( P = .12). Study 2 had 2 dislocations (0.4%). Dislocation rates in primary THA with 38-mm bearings via posterior approach are the same as 28-mm bearings via Hardinge approach. Metal-on-metal THA with 38 to 56 mm heads is also associated with low dislocation rates (0.4%) at short-term follow-up.