Minimal invasive posterior total hip arthroplasty: are 6 weeks of hip precautions really necessary?

Arch Orthop Trauma Surg. 2015 Feb;135(2):271-274. doi: 10.1007/s00402-014-2146-x. Epub 2015 Jan 4.

Abstract

Introduction: Postoperative hip dislocations have been reported in 0.5 to 10.6 % of patients after primary posterolateral total hip arthroplasty (THA). Hip precautions are currently recommended for 6 weeks postoperatively to reduce early dislocation and facilitate healing of the posterior soft tissue repair.

Materials and methods: To determine the impact of a modified 4-week precaution protocol on the dislocation rate, 698 consecutive patients (797 hips) operated by a single surgeon between September 2008 and December 2012 were retrospectively evaluated. All patients had a standard THA using a minimal invasive posterior approach with posterior soft tissue repair and 28-36-mm head size. 98.7 % of the patients were available for follow-up.

Results: There were eight (1 %) dislocations in 797 hips in the first 12 months after surgery with 4 weeks of hip precautions. The average time to dislocation was 7.5 weeks after surgery (range 1.0-16.9 weeks); two dislocations (25 %) took place in the first 4 weeks.

Conclusions: Shortening the time of posterolateral hip precautions from 6 to 4 weeks after surgery does not increase the risk of postoperative dislocation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Female
  • Hip Dislocation / etiology
  • Hip Dislocation / prevention & control*
  • Hip Joint / surgery*
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Postoperative Care
  • Retrospective Studies
  • Young Adult