Abstract
Introduction: Instability after total hip arthroplasty is an important complication. It commonly occurs in the immediate postoperative period, but the risk is reported to continue over time. There are numerous surgical treatment options, but they have relatively unpredictable outcomes. Numerous factors have been associated with dislocation, but research has mainly focused on surgical factors. Epidemiological factors remain the subject of much debate. We aimed to establish the incidence of dislocation over time.
Methods: The Scottish National arthroplasty non-voluntary registry is based on SMR01 records (Scottish Morbidity Record) data. We analyzed the Scottish National Arthroplasty Project to find patients’ dislocation rates up to 12 years post surgery.
Results: There were 62,175 total hip arthroplasties performed from April 1989 to March 2004 with an annual incidence of dislocation of 0.9%. The majority of dislocations occur by 12 months (66%) but patients remain at relatively high risk even after the first 3 months by when only 23% of the total have occurred. We found no increase in the rate of dislocation after 2 years.
Discussion: Patients should be warned that the risk of dislocation remains for the first year. However, it appears there is no late increase in dislocation rate associated with wear and declining mental or muscle function.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
