A multimodal approach prevents instability after total hip arthroplasty: A 1 year follow-up prospective study

Introduction: Joint dislocation is one of the most frequent complications after hip arthroplasty. Multiple strategies have demonstrated ability to prevent instability when used in isolation, but the effect when more than one intervention is implemented has not been measured. The purpose of this stud...

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Autores:
Tipo de recurso:
Fecha de publicación:
2018
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/22306
Acceso en línea:
https://doi.org/10.1016/j.jcot.2016.11.004
https://repository.urosario.edu.co/handle/10336/22306
Palabra clave:
Aged
Article
Clinical protocol
Cohort analysis
Controlled study
Female
Femoral head
Follow up
Hip arthroplasty
Hip dislocation
Hip osteoarthritis
Human
Joint instability
Major clinical study
Male
Medical documentation
Medical record
Patient education
Peroperative care
Postoperative period
Priority journal
Prospective study
Soft tissue
Tissue repair
Arthroplasty
Combined modality therapy
Hip
Hip dislocation
Prevention and control
Replacement
Rights
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Abierto (Texto Completo)
Description
Summary:Introduction: Joint dislocation is one of the most frequent complications after hip arthroplasty. Multiple strategies have demonstrated ability to prevent instability when used in isolation, but the effect when more than one intervention is implemented has not been measured. The purpose of this study is to assess the rate of dislocation after implementation of a protocol of combined strategies for prevention of instability. Materials and methods: Consecutive patients undergoing primary total hip replacement for hip osteoarthritis between February 2012 and June 2014 were included. A multimodal protocol including patient education, use of large femoral heads, posterior soft-tissue repair, and intraoperative adjustment of limb length and hip offset was applied. Dislocation episodes were documented trough medical records review and a telephonic follow-up at 3 and 12 months after surgery. Results: During the period of study 331 patients were included, mean age was 66 years and 68.8% were females. Only 0.91% of patients were lost to follow-up. Eighty-nine percent of patients received all interventions. Cumulative dislocation rate at 3 months was 0.60% and 0.90% at 12 months. Conclusions: The implementation of a multimodal protocol for prevention of prosthesis instability produces a low rate of dislocation, which compares favorably with benchmarks. We recommend the use of a combination of multiple interventions to prevent this complication. © 2016