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Randomized Controlled Trial
. 2006 Aug;30(4):233-6.
doi: 10.1007/s00264-005-0064-9. Epub 2006 Mar 7.

Dynamics of hip joint effusion after posterior soft tissue repair in total hip arthroplasty

Sarunas Tarasevicius  1 , Uldis Kesteris, Romas Jonas Kalesinskas, Hans Wingstrand
Affiliations
Randomized Controlled Trial

Dynamics of hip joint effusion after posterior soft tissue repair in total hip arthroplasty

Sarunas Tarasevicius et al. Int Orthop. 2006 Aug.

Abstract
in English, French

Dislocation after total hip replacement is more common in the early, postoperative period. Postoperative intraarticular haematoma and remaining seroma fluid and/or weakened posterior soft tissue wall may be contributing factors. Our purpose was to compare and follow with sonography the resorption of the postoperative volume of intraarticular fluid/synovial oedema after total hip arthroplasty (THA) with or without posterior soft tissue repair. Thirty-three consecutive patients with hip osteoarthritis were admitted for THA. All of them received the same type of cemented implant. Patients were randomised for posterior soft tissue repair or not. Sonography, measuring the anterior capsular distension, indicating the volume of intraarticular fluid/synovial oedema in the prosthetic hip joints, was performed after six and 12 months in all patients. At six months postoperatively greater capsular distension, i.e., remaining volume of intraarticular fluid/synovial oedema, was observed in the group with posterior soft tissue repair than in the group without. After one year the capsular distension had decreased in both groups and there was no significant difference between the groups. Our results show that posterior soft tissue repair after THA is associated with increased capsular distension during the first six months. After 12 months the volume of intraarticular fluid/synovial oedema is the same with or without posterior soft tissue repair.

La luxation après prothèse totale de la hanche est plus fréquente précocement, en période postopératoire. L’hématome intra-articulaire et /ou l’altération des tissus postérieurs peuvent être des facteurs de cette luxation. Nous avons étudiés par échographie la résorption postopératoire des fluides articulaires et de l’œdème synovial après arthroplastie totale de la hanche faite avec ou sans réparation des tissus postérieurs. 33 patients consécutifs, opérés avec le même type d’implant cimenté furent randomisés vis-à-vis de la réparation, ou non, des tissus postérieurs. L’échographie, mesurant la distension capsulaire antérieure a été faite après 6 et 12 mois chez tous les patients. A 6 mois de l’intervention une augmentation de la distension capsulaire c’est à dire du volume liquidien résiduel était observée dans le groupe avec réparation des tissus postérieurs comparé au groupe sans réparation. Après 1 an la distension décroît dans les deux groupes sans différence significative entre les deux.

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Figures

Fig. 1
Fig. 1
Schematic drawing showing sonographic findings in THA patients. FH Prosthetic femoral head; FN prosthetic femoral neck; AC anterior capsule; d distance between anterior capsule and prosthetic femoral neck; 1 echo from FH; 2 echo from FN; 3 echo from prosthetic collar (not always present)
Fig. 2
Fig. 2
Sonographic measurement of the “capsular distance” in THA. AC Echo from anterior surface of anterior hip joint capsule; FN echo from anterior surface of prosthetic femoral neck; FH echo from anterior surface of prosthetic femoral head; dotted line distance between anterior capsule and prosthetic femoral neck
Fig. 3
Fig. 3
The dynamic of changes in capsular distension with and without posterior soft tissue repair at 6 and 12 months after THA
See this image and copyright information in PMC

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