Dislocation after total hip arthroplasty

Hip dislocation has long been one of the major complications after total hi p arthroplasty (THA), From 1980 to 1994, we performed 2728 THAs (including primary and revision cases). There were 97 hips (3.6%) with the complicatio n of dislocation, 62 of which were followed up for at least 2 years (mean 5 .3 years; range 2-12 years), Single dislocations occurred in 40% and recurr ent dislocations in 60%. More than half of the dislocations (58%) occurred within 3 months after the index operation. The dislocation rate was not rel ated to sex, age, previous revision surgery, or types of prosthesis, but wa s related to a smaller size of the femoral head. The rate of recurrent disl ocation was not related to a history of previous surgery, but was related t o a smaller femoral head, late onset of dislocation (> 3 months), soft-tiss ue imbalance, and cup malposition in both anteversion and inclination. If t he size of the femoral head was 26 mm or smaller, a posterior approach was not recommended. Closed reduction followed by 1-2 weeks of skin traction wa s the treatment of choice. The success rate for the first attempt at closed reduction for the treatment of dislocation was 41%; the success rate decre ased gradually with the number of attempts. For the recurrent dislocation g roup, bracing for 4-6 weeks with training was recommended for the postural type and bracing for 3 months with muscle training for the soft-tissue imba lance type. Only 15% of the dislocated hips needed re-operation, and most o f the patients resolved the problem after being informed and undergoing mus cle training.