Abstract

Dislocation is one of the most common complications of total hip arthroplasty. The diameter of the femoral head is one of the more important of the variables under the control of the surgeon. We followed 527 total hip arthroplasties in 469 patients after primary total hip arthroplasty with femoral head sizes ranging from 28 to 44 mm. All surgeries were performed by a single surgeon at one institution. The operative approach was the posterior approach in all patients. The patients were followed at defined intervals and asked about dislocation. There was a mean follow up of 60 months with a range of 12 to 138 months. In total hip arthroplasty, utilizing the posterior approach, we found no statistically significant association between the risk of dislocation and femoral head size.

Highlights

  • Dislocation is one of the most common complications of Total Hip Arthroplasty (THA)

  • Since the advent of highly cross-linked polyethylene bearings there has been a trend toward using larger femoral heads in total hip arthroplasty with the thought that the increased impingement free range of motion and greater amount of femoral head translation would decrease the rate of dislocation as suggested by a few studies [18,19,20,21,22,23]

  • We hypothesized that larger femoral head size would be associated with a decreased rate of dislocation when tested in vivo

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Summary

Introduction

Dislocation is one of the most common complications of Total Hip Arthroplasty (THA). In addition to optimizing the femoral and acetabular component positioning, maximizing the diameter of the femoral head has been touted as another important intra-operative tool available to the surgeon to decrease dislocation rates. Maximization of the femoral head size is limited and is not without consequence. Femoral head size is determined intra-operatively by the surgeon and is dependent on the size of the acetabular component and the thickness of the liner if a modular acetabular component is utilized. If a modular acetabular component with a polyethylene liner is utilized, there is an obvious trade off of minimization of the thickness of the polyethylene for maximization of the femoral head size. With the advent of highly cross-linked polyethylene and the resultant decreased wear rates, there is a theoretical offset of the increased wear due to larger head sizes and this has led to more widespread use of larger femoral heads in THA

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