Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors

Christoffer Calov Jørgensen; Per Kjaersgaard-Andersen; Søren Solgaard; Henrik Kehlet; Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group

doi:10.1007/s00402-014-2051-3

Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors

Christoffer Calov Jørgensen, Per Kjaersgaard-Andersen, Søren Solgaard, Henrik Kehlet, Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group

Institut for Klinisk Medicin

34 Citationer (Scopus)

Abstract

STUDY DESIGN: Retrospective review of prospectively collected data.

OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors.

METHODS: Prospective data on preoperative patient characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmissions, including emergency-room contacts. Complete patient files and postoperative radiographs were reviewed in case of dislocations. Unadjusted comparisons were made using t test/Chi-square analyses, while evaluation of risk factors potentially predisposing to dislocations was done using uni- and multivariate regression analysis.

RESULTS: A total of 2,734 consecutive unselected procedures were available for analysis, of which 65 (2.4 %) had dislocations. Of these, eight were during index admission and five were treated and discharged from the emergency room. Mechanisms of dislocation were most often movement while supine or sitting for the first 30 days and due to squatting/bending from day 31 to 90. The 65 patients with dislocations had suboptimal cup placement in 34 (52.3 %), and a femoral head size of <36 mm in 20 (30.8 %) cases. Predisposing factors of dislocation were age ≥75 [OR:1.96 (1.18-3.38)], pharmacologically treated psychiatric disease [OR:2.37 (1.29-4.36)] and department of surgery [OR:2.27 (1.31-3.40)] but not hospital stay of <4 days. Departments with recommendations for activity restrictions had fewer dislocations than a department without restrictions.

CONCLUSIONS: Patients ≥75 years and with pharmacologically treated psychiatric disease may be at increased risk of dislocations after fast-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation.

Originalsprog	Engelsk
Tidsskrift	Archives of Orthopaedic and Trauma Surgery
Vol/bind	134
Udgave nummer	11
Sider (fra-til)	1615-1622
Antal sider	8
ISSN	0936-8051
DOI	https://doi.org/10.1007/s00402-014-2051-3
Status	Udgivet - nov. 2014

Adgang til dokumentet

10.1007/s00402-014-2051-3

Citationsformater

Jørgensen, C. C., Kjaersgaard-Andersen, P., Solgaard, S., Kehlet, H., & Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group (2014). Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors. Archives of Orthopaedic and Trauma Surgery, 134(11), 1615-1622. https://doi.org/10.1007/s00402-014-2051-3

Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties : incidence, circumstances and predisposing factors. / Jørgensen, Christoffer Calov; Kjaersgaard-Andersen, Per; Solgaard, Søren et al.

I: Archives of Orthopaedic and Trauma Surgery, Bind 134, Nr. 11, 11.2014, s. 1615-1622.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Jørgensen, CC, Kjaersgaard-Andersen, P, Solgaard, S, Kehlet, H & Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group 2014, 'Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors', Archives of Orthopaedic and Trauma Surgery, bind 134, nr. 11, s. 1615-1622. https://doi.org/10.1007/s00402-014-2051-3

Jørgensen CC, Kjaersgaard-Andersen P, Solgaard S, Kehlet H, Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group. Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors. Archives of Orthopaedic and Trauma Surgery. 2014 nov.;134(11):1615-1622. doi: 10.1007/s00402-014-2051-3

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title = "Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors",

abstract = "STUDY DESIGN: Retrospective review of prospectively collected data.OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors.METHODS: Prospective data on preoperative patient characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmissions, including emergency-room contacts. Complete patient files and postoperative radiographs were reviewed in case of dislocations. Unadjusted comparisons were made using t test/Chi-square analyses, while evaluation of risk factors potentially predisposing to dislocations was done using uni- and multivariate regression analysis.RESULTS: A total of 2,734 consecutive unselected procedures were available for analysis, of which 65 (2.4 %) had dislocations. Of these, eight were during index admission and five were treated and discharged from the emergency room. Mechanisms of dislocation were most often movement while supine or sitting for the first 30 days and due to squatting/bending from day 31 to 90. The 65 patients with dislocations had suboptimal cup placement in 34 (52.3 %), and a femoral head size of <36 mm in 20 (30.8 %) cases. Predisposing factors of dislocation were age ≥75 [OR:1.96 (1.18-3.38)], pharmacologically treated psychiatric disease [OR:2.37 (1.29-4.36)] and department of surgery [OR:2.27 (1.31-3.40)] but not hospital stay of <4 days. Departments with recommendations for activity restrictions had fewer dislocations than a department without restrictions.CONCLUSIONS: Patients ≥75 years and with pharmacologically treated psychiatric disease may be at increased risk of dislocations after fast-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation.",

keywords = "Adult, Age Factors, Aged, Arthroplasty, Replacement, Hip, Denmark, Elective Surgical Procedures, Female, Hip Dislocation, Humans, Incidence, Length of Stay, Male, Middle Aged, Registries, Retrospective Studies, Risk Factors, Time Factors",

author = "J{\o}rgensen, {Christoffer Calov} and Per Kjaersgaard-Andersen and S{\o}ren Solgaard and Henrik Kehlet and {Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group}",

year = "2014",

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doi = "10.1007/s00402-014-2051-3",

language = "English",

volume = "134",

pages = "1615--1622",

journal = "Archives of Orthopaedic and Trauma Surgery",

issn = "0936-8051",

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T1 - Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties

T2 - incidence, circumstances and predisposing factors

AU - Jørgensen, Christoffer Calov

AU - Kjaersgaard-Andersen, Per

AU - Solgaard, Søren

AU - Kehlet, Henrik

AU - Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group

PY - 2014/11

Y1 - 2014/11

N2 - STUDY DESIGN: Retrospective review of prospectively collected data.OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors.METHODS: Prospective data on preoperative patient characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmissions, including emergency-room contacts. Complete patient files and postoperative radiographs were reviewed in case of dislocations. Unadjusted comparisons were made using t test/Chi-square analyses, while evaluation of risk factors potentially predisposing to dislocations was done using uni- and multivariate regression analysis.RESULTS: A total of 2,734 consecutive unselected procedures were available for analysis, of which 65 (2.4 %) had dislocations. Of these, eight were during index admission and five were treated and discharged from the emergency room. Mechanisms of dislocation were most often movement while supine or sitting for the first 30 days and due to squatting/bending from day 31 to 90. The 65 patients with dislocations had suboptimal cup placement in 34 (52.3 %), and a femoral head size of <36 mm in 20 (30.8 %) cases. Predisposing factors of dislocation were age ≥75 [OR:1.96 (1.18-3.38)], pharmacologically treated psychiatric disease [OR:2.37 (1.29-4.36)] and department of surgery [OR:2.27 (1.31-3.40)] but not hospital stay of <4 days. Departments with recommendations for activity restrictions had fewer dislocations than a department without restrictions.CONCLUSIONS: Patients ≥75 years and with pharmacologically treated psychiatric disease may be at increased risk of dislocations after fast-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation.

AB - STUDY DESIGN: Retrospective review of prospectively collected data.OBJECTIVE: To investigate the incidence of hip dislocation 90 days after total hip arthroplasty in relation to time after surgery, mechanism of dislocation and predisposing factors.METHODS: Prospective data on preoperative patient characteristics from six Danish arthroplasty departments with similar fast-track approaches were cross-referenced with the Danish National Patient Registry for complete 90-day follow-up on readmissions, including emergency-room contacts. Complete patient files and postoperative radiographs were reviewed in case of dislocations. Unadjusted comparisons were made using t test/Chi-square analyses, while evaluation of risk factors potentially predisposing to dislocations was done using uni- and multivariate regression analysis.RESULTS: A total of 2,734 consecutive unselected procedures were available for analysis, of which 65 (2.4 %) had dislocations. Of these, eight were during index admission and five were treated and discharged from the emergency room. Mechanisms of dislocation were most often movement while supine or sitting for the first 30 days and due to squatting/bending from day 31 to 90. The 65 patients with dislocations had suboptimal cup placement in 34 (52.3 %), and a femoral head size of <36 mm in 20 (30.8 %) cases. Predisposing factors of dislocation were age ≥75 [OR:1.96 (1.18-3.38)], pharmacologically treated psychiatric disease [OR:2.37 (1.29-4.36)] and department of surgery [OR:2.27 (1.31-3.40)] but not hospital stay of <4 days. Departments with recommendations for activity restrictions had fewer dislocations than a department without restrictions.CONCLUSIONS: Patients ≥75 years and with pharmacologically treated psychiatric disease may be at increased risk of dislocations after fast-track total hip arthroplasty. Further studies including detailed information on patient and prosthesis characteristics, and activity restrictions are needed to reduce the risk of dislocation.

KW - Adult

KW - Age Factors

KW - Aged

KW - Arthroplasty, Replacement, Hip

KW - Denmark

KW - Elective Surgical Procedures

KW - Female

KW - Hip Dislocation

KW - Humans

KW - Incidence

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Registries

KW - Retrospective Studies

KW - Risk Factors

KW - Time Factors

U2 - 10.1007/s00402-014-2051-3

DO - 10.1007/s00402-014-2051-3

M3 - Journal article

C2 - 25118616

SN - 0936-8051

VL - 134

SP - 1615

EP - 1622

JO - Archives of Orthopaedic and Trauma Surgery

JF - Archives of Orthopaedic and Trauma Surgery

IS - 11

ER -

Hip dislocations after 2,734 elective unilateral fast-track total hip arthroplasties: incidence, circumstances and predisposing factors

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