Abstract
Purpose
There is scant literature on the evaluation of dislocation after total hip arthroplasty (THA) in patients with ipsilateral valgus knee deformity. This study aimed to investigate the post-operative dislocation rate in patients with valgus knee deformity who underwent ipsilateral THA and identify whether ipsilateral valgus knee deformity increases the dislocation rate after THA.
Methods
We retrospectively reviewed patients with valgus knee deformity who underwent ipsilateral THA in our institution from January 2016 to December 2018. Each hip with ipsilateral valgus knee deformity was matched with a hip without valgus knee deformity according to sex, affected side, and date of surgery. The primary outcome was the dislocation rate after THA. Univariate analyses were initially used to compare data between the dislocation group and the non-dislocation group. Independent risk factors for dislocation were determined using multivariate logistic regression.
Results
There were 257 THAs with ipsilateral valgus knee deformity (valgus knee group) and 257 THAs without valgus knee deformity (control group). The valgus knee group showed a significantly higher dislocation rate than the control group (9.7% versus 1.6%, p < 0.001). Older age (p = 0.020) and malposition of the acetabular cup (p = 0.048) were independent risk factors of post-operative dislocation.
Conclusion
Patients with valgus knee deformity have a higher risk of dislocation after ipsilateral THA. If ipsilateral THA and total knee arthroplasty must be performed successively, total knee arthroplasty may have an earlier priority than THA.
Similar content being viewed by others
Availability of data and materials
We will present all the data in this article when necessary.
References
Gwam CU, Mistry JB, Mohamed NS, Thomas M, Bigart KC, Mont MA, Delanois RE (2017) Current epidemiology of revision total hip arthroplasty in the United States: national inpatient sample 2009 to 2013. J Arthroplasty 32(7):2088–2092
Ding ZC, Xu B, Liang ZM, Wang HY, Luo ZY, Zhou ZK (2020) Limited influence of comorbidities on length of stay after total hip arthroplasty: experience of enhanced recovery after surgery. Orthop Surg 12(1):153–161
Ding ZC, Zeng WN, Mou P, Liang ZM, Wang D, Zhou ZK (2020) Risk of dislocation after total hip arthroplasty in patients with crowe type iv developmental dysplasia of the hip. Orthop Surg 12(2):589–600
Rowan FE, Benjamin B, Pietrak JR, Haddad FS (2018) Prevention of dislocation after total hip arthroplasty. J Arthroplasty 33(5):1316–1324
Malkani AL, Ong KL, Lau E, Kurtz SM, Justice BJ, Manley MT (2010) Early- and late-term dislocation risk after primary hip arthroplasty in the medicare population. J Arthroplasty 25(6 Suppl):21–25
Bozic KJ, Kamath AF, Ong K, Lau E, Kurtz S, Chan V, Vail TP, Rubash H, Berry DJ (2015) Comparative epidemiology of revision arthroplasty: failed tha poses greater clinical and economic burdens than failed TKA. Clin Orthop Relat Res 473(6):2131–2138
Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ (2009) The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 91(1):128–133
Liu Q, Cheng X, Yan D, Zhou Y (2019) Plain radiography findings to predict dislocation after total hip arthroplasty. J Orthop Transl 18:1–6
Kotwal RS, Ganapathi M, John A, Maheson M, Jones SA (2009) Outcome of treatment for dislocation after primary total hip replacement. J Bone Joint Surg Br 91(3):321–326
Abdel MP, Cross MB, Yasen AT, Haddad FS (2015) The functional and financial impact of isolated and recurrent dislocation after total hip arthroplasty. Bone Joint J 97-b(8):1046–1049
Sanchez-Sotelo J, Haidukewych GJ, Boberg CJ (2006) Hospital cost of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am 88(2):290–294
Buckland AJ, Puvanesarajah V, Vigdorchik J, Schwarzkopf R, Jain A, Klineberg EO, Hart RA, Callaghan JJ, Hassanzadeh H (2017) Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J 99-b(5):585–591
Saiz AM, Lum ZC, Pereira GC (2019) Etiology, evaluation, and management of dislocation after primary total hip arthroplasty. JBJS Rev 7(7):11
Gausden EB, Parhar HS, Popper JE, Sculco PK, Rush BNM (2018) Risk factors for early dislocation following primary elective total hip arthroplasty. J Arthroplasty 33(5):1567-1571 e1562
Jämsen E, Puolakka T, Peltola M, Eskelinen A, Lehto MU (2014) Surgical outcomes of primary hip and knee replacements in patients with Parkinson’s disease: a nationwide registry-based case-controlled study. Bone Joint J 96-b(4):486–491
Lange J, Haas SB (2017) Correcting severe valgus deformity: taking out the knock. Bone Joint J 99-b(1 Supple A):60–64
Kawaguchi K, Inui H, Taketomi S, Yamagami R, Takagi K, Kage T, Sameshima S, Tanaka S (2021) Rotational kinematics differ between mild and severe valgus knees in total knee arthroplasty. Knee 28:81–88
Nikolopoulos D, Michos I, Safos G, Safos P (2015) Current surgical strategies for total arthroplasty in valgus knee. World J Orthop 6(6):469–482
Meding JB, Faris PM, Davis KE (2017) Bilateral total hip and knee arthroplasties: average 10-year follow-up. J Arthroplasty 32(11):3328–3332
Guo SJ, Zhou YX, Yang DJ, Yang XC (2012) Lower-limb valgus deformity associated with developmental hip dysplasia. Chin Med J 125(22):3956–3960
Zhao HY, Kang PD, **a YY, Shi XJ, Nie Y, Pei FX (2017) Comparison of early functional recovery after total hip arthroplasty using a direct anterior or posterolateral approach: a randomized controlled trial. J Arthroplasty 32(11):3421–3428
Harsten A, Kehlet H, Ljung P, Toksvig-Larsen S (2015) Total intravenous general anaesthesia vs. spinal anaesthesia for total hip arthroplasty: a randomised, controlled trial. Acta Anaesth Scand 59(3):298–309
Ranawat CS, Ranawat AS, Rasquinha VJ (2004) Mastering the art of cemented femoral stem fixation. J Arthroplasty 19(4 Suppl 1):85–91
Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60(2):217–220
Pradhan R (1999) Planar anteversion of the acetabular cup as determined from plain anteroposterior radiographs. J Bone Joint Surg Br 81(3):431–435
Wera GD, Ting NT, Moric M, Paprosky WG, Sporer SM, Della Valle CJ (2012) Classification and management of the unstable total hip arthroplasty. J Arthroplasty 27(5):710–715
Kim JT, Kim HS, Lee YK, Ha YC, Koo KH (2020) Total hip arthroplasty with trochanteric ostectomy for patients with angular deformity of the proximal femur. J Arthroplasty 35(10):2911–2918
Maisongrosse P, Lepage B, Cavaignac E, Pailhe R, Reina N, Chiron P, Laffosse JM (2015) Obesity is no longer a risk factor for dislocation after total hip arthroplasty with a double-mobility cup. Int Orthop 39(7):1251–1258
Weinstein SL (1987) Natural history of congenital hip dislocation (cdh) and hip dysplasia. Clin Orthop Relat Res 225:62–76
Zhou X, Wang Q, Zhang X, Chen Y, Shen H, Jiang Y (2012) Effect of pelvic obliquity on the orientation of the acetabular component in total hip arthroplasty. J Arthroplasty 27(2):299–304
Malkani AL, Dilworth B, Ong K, Baykal D, Lau E, Mackin TN, Lee GC (2017) High risk of readmission in octogenarians undergoing primary hip arthroplasty. Clin Orthop Relat Res 475(12):2878–2888
Esposito CI, Gladnick BP, Lee YY, Lyman S, Wright TM, Mayman DJ, Padgett DE (2015) Cup position alone does not predict risk of dislocation after hip arthroplasty. J Arthroplasty 30(1):109–113
Jørgensen CC, Kjaersgaard-Andersen P, Solgaard S, Kehlet H (2014) Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors. Arch Orthop Trauma Surg 134(11):1615–1622
McElwain JP, Sheehan JM (1985) Bilateral hip and knee replacement for rheumatoid arthritis. J Bone Joint Surg Br 67(2):261–265
Johnson KA (1975) Arthroplasty of both hips and both knees in rheumatoid arthritis. J Bone Joint Surg Am 57(7):901–904
McDonald I (1982) Bilateral replacement of the hip and knee in rheumatoid arthritis. J Bone Joint Surg Br 64(4):465–468
Suman RK, Freeman PA (1986) Bilateral hip and knee replacement in rheumatoid arthritis. J Arthroplasty 1(4):237–240
Basques BA, Toy JO, Bohl DD, Golinvaux NS, Grauer JN (2015) General compared with spinal anesthesia for total hip arthroplasty. J Bone Joint Surg Am 97(6):455–461
Chang CC, Lin HC, Lin HW, Lin HC (2010) Anesthetic management and surgical site infections in total hip or knee replacement: a population-based study. Anesthesiology 113(2):279–284
Helwani MA, Avidan MS, Ben Abdallah A, Kaiser DJ, Clohisy JC, Hall BL, Kaiser HA (2015) Effects of regional versus general anesthesia on outcomes after total hip arthroplasty: a retrospective propensity-matched cohort study. J Bone Joint Surg Am 97(3):186–193
Mauermann WJ, Shilling AM, Zuo Z (2006) A comparison of neuraxial block versus general anesthesia for elective total hip replacement: a meta-analysis. Anesth Analg 103(4):1018–1025
Harsten A, Kehlet H, Toksvig-Larsen S (2013) Recovery after total intravenous general anaesthesia or spinal anaesthesia for total knee arthroplasty: a randomized trial. Br J Anaesth 111(3):391–399
Li H, Zeng WN, Ding ZC, Yuan MC, Cai YR, Zhou ZK (2021) Duloxetine reduces pain after total hip arthroplasty: a prospective, randomized controlled study. BMC Musculoskelet Disord 22(1):492
Zahar A, Rastogi A, Kendoff D (2013) Dislocation after total hip arthroplasty. Curr Rev Musculoskelet Med 6(4):350–356
Funding
This work was supported by the 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC18039); and the Regional Innovation & Cooperation program of the Science & Technology Department of Sichuan Province (No. 2021YFQ0028).
Author information
Authors and Affiliations
Contributions
All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by **-Wei **e, Zi-Chuan Ding, Ming-Cheng Yuan, Ya-Hao Lai, and Zong-Ke Zhou. The first draft of the manuscript was written by Hao Li, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the institutional review board.
Consent to participate
Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.
Consent for publication
Written informed consent for publication was obtained from all participants.
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Li, H., **e, JW., Ding, ZC. et al. Evaluation of the rate of post-operative dislocation in patients with ipsilateral valgus knee deformity after primary total hip arthroplasty. International Orthopaedics (SICOT) 46, 1507–1514 (2022). https://doi.org/10.1007/s00264-022-05372-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-022-05372-7