The analysis of posterior soft tissue repair durability after total hip arthroplasty in primary osteoarthritis patients

Abstract

Background and purpose: The posterior soft tissue repair is 1 of the preventing factors for dislocation after total hip arthroplasty (THA).The aim of our study was to analyse THA patients with posterior soft tissue repair in terms of suture durability, time of suture failure and correlate the changes in leg length and offset postoperatively to suture durability.

Methods: A total of 37 consecutive THA patients operated for osteoarthritis were included in the study. The posterior repair included reattaching the piriformis, conjoined tendons and posterior capsule to the greater trochanter through 2, 2 mm drill holes with 2 grasping stitches. A metal indicator wire was stitched into the piriformis tendon at distance of 1 cm from the greater trochanter after the prosthesis had been implanted and the joint reduced. Anteroposterior radiographs were taken immediately after the patients returned from the operating theatre to the intensive care unit, the next day after mobilisation, and at the 5th day of stay and at 3 months postoperatively.

Results: Out of 37 THA hips, 6 (16%) had failed immediately after surgery, 25 (68%) at the 1st postoperative day after mobilisation, 2 (5%) at the 5th postoperative day, and 1 (3%) repairs had failed at 3 months after THA. In the remaining 3 hips no failure occurred.

Interpretation: We conclude that posterior soft tissue repair in THA often fails and suggest that new posterior soft tissue repair methods be developed.