The effect of acetabular and femoral component version on dislocation in primary total hip arthroplasty

Abstract

Purpose: The purpose of the present study was to: (1) investigate the variation of both acetabular and femoral component version in a large series of consecutive primary THA patients, and (2) to better define the associations of acetabular and femoral component alignment and clinical factors with subsequent hip dislocation in those patients.

Methods: We analyzed CT scans of 1,555 consecutive primary THAs and measured version of the components. We also documented the frequency and direction of subsequent dislocation as well as femoral head size, posterior tissue repair, any history of previous hip surgery, and gender.

Results: The dislocation rate after THA was 3.22 %. The dislocation risk was 1.9 times higher if cup anteversion was not between 10° and 30°. Compared to hips that did not dislocate, those that experienced anterior dislocation had a significantly greater combined anteversion; those that dislocated posteriorly had a significantly smaller combined anteversion. Hips with previous rotational acetabular osteotomy or head size smaller than 28 mm correlated with an increased dislocation rate.

Conclusion: The dislocation risk could be higher if cup anteversion was not between 10° and 30°. Greater combined anteversion could be a risk factor of anterior dislocation, and posterior dislocation could be more common in smaller combined anteversion.

Keywords: Component version; Computed tomography; Dislocation; Total hip arthroplasty.