Abstract
Recurrent posterior dislocation is a recognised complication following primary total hip arthroplasty. Incidences of between 0.11% and 4.5% have been reported in the literature.
Component revision is regarded as standard management of recurrent posterior dislocation. However, revision surgery is a major surgical procedure and is often unsuitable for elderly, frail patients.
A congruent, ultra-high molecular weight polyethylene acetabular augment with a stainless steel backing plate has been developed. This can be inserted providing there is no malalignment, wear or loosening of the primary components.
In this study we compared twenty patients who underwent conventional revision surgery to twenty patients who had a PLAD inserted for recurrent posterior dislocation following primary Charnley total hip arthroplasty. Both groups were age and sex-matched and the average number of dislocations prior to surgery was three for each group.
For the PLAD group, the mean operative time, the mean intraoperative blood loss, the time spent in HDU, the transfusion requirements and the duration of hospital stay was significantly less than that for the revision group. Furthermore, there was no significant difference in the Oxford Hip Score recorded preoperatively and at 6 weeks, 6 months, one year and two years following surgery. None of the patients had sustained a further dislocation at latest review.
We conclude that the Posterior Lip Augmentation Device is a safe and effective option in the management of patients with recurrent posterior hip dislocation when there is no evidence of component failure or gross malposition.
The abstracts were prepared by Peter Kay. Correspondence should be addressed to him at Centre for Hip Surgery, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP.
