Enhanced soft tissue repair using locking loop stitch after posterior approach for hip hemiarthroplasty

Hemiarthroplasty of the hip for displaced fracture of the femoral neck (inc luding Austin-Moore and Thompson arthroplasties) frequently is performed by orthopaedic surgeons. The posterior approach is used despite the slight in crease in risk of postoperative dislocation. The outcome after dislocation can be disastrous. We tried to prevent this complication hy repairing the p osterior capsule and the short external rotators (piriformis, superior and inferior gemellus. obturator internus, and upper part of quadratus femoris) using locking loop stitch as described by Krackow. From January 1998 to Ap ril 1999, 205 hips were operated on and followed up for >3 months: no dislo cation was found. Using the past records as the comparative group, 28 poste rior dislocations (1.9%) were found in 1,483 hip hemiarthroplasties using t he posterior approach (P < .05 using exact probability test). Enhanced soft tissue repair with locking loop stitch is an effective way to reduce the i ncidence of dislocation after hip hemiarthroplasty using the posterior appr oach.