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Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume 90(3):506-516 March 1, 2008 ©2008 by The Journal of Bone and Joint Surgery, Inc.

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Page 1: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty

by Alexander P. Sah, and Daniel M. Estok

J Bone Joint Surg AmVolume 90(3):506-516

March 1, 2008

©2008 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

Abduction angle of the acetabular component (theta), defined by the angle between a horizontal line at the base of the ischia and a line parallel to the acetabular component on an

anteroposterior pelvic radiograph.

Alexander P. Sah, and Daniel M. Estok II J Bone Joint Surg Am 2008;90:506-516

©2008 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

Acetabular anteversion, defined as the angle (alpha) between a vertical line and a line parallel to the acetabular component on a shoot-through lateral radiograph of the hip.

Alexander P. Sah, and Daniel M. Estok II J Bone Joint Surg Am 2008;90:506-516

©2008 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

Bar chart showing the percentage of dislocations associated with each femoral head size used in the conversions of the hemiarthroplasties and in the first-time revisions of the total hip

arthroplasties.

Alexander P. Sah, and Daniel M. Estok II J Bone Joint Surg Am 2008;90:506-516

©2008 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

Figs. 3-A, 3-B, and 3-C Diagrams illustrating the effects of “femoral head downsizing” with conversion from a hemiarthroplasty to a total hip replacement.

Alexander P. Sah, and Daniel M. Estok II J Bone Joint Surg Am 2008;90:506-516

©2008 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

The reduction in the femoral head size after conversion surgery results in increased relative laxity of the soft tissues, which have been previously compromised by the index procedure.

Alexander P. Sah, and Daniel M. Estok II J Bone Joint Surg Am 2008;90:506-516

©2008 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Dislocation Rate After Conversion from Hip Hemiarthroplasty to Total Hip Arthroplasty by Alexander P. Sah, and Daniel M. Estok J Bone Joint Surg Am Volume

Dislocation is more likely to occur with smaller head sizes, since these represent the greatest amount of femoral head downsizing in the context of compromised soft tissues.

Alexander P. Sah, and Daniel M. Estok II J Bone Joint Surg Am 2008;90:506-516

©2008 by The Journal of Bone and Joint Surgery, Inc.

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