Introduction: Dislocation following total hip arthroplasty is a recognised complication and is attributable to several factors. The posterior approach to the hip is associated with higher dislocation rates than anterior or lateral approaches. We retrospectively reviewed the incidence of dislocation following total hip arthroplasty, in our institution, over a period of 5 years (from January 2000 to December 2004).

Results: We found 97 instances (in 49 patients) of dislocation following total hip arthroplasty. Of the 49 patients, 35 had the total hip arthroplasty done through the posterior approach. The Stacathro approach was performed on one patient, antero-lateral approach in 7 patients, and the transtrochanteric approach on 6 patients. Eleven patients had undergone revision arthroplasty prior to sustaining a dislocation and 16 had undergone primary arthroplasty. 16 patients had multiple dislocations. 8 of the 16 with multiple dislocations had a primary arthroplasty and rest had revision procedures done. A number of authors have reported decreased dislocation rates after using various techniques for enhancing the closure of the posterior soft tissues following total hip arthroplasties using the posterior approach. We reviewed 256 patient records that had undergone total hip arthroplasty in this period by the senior author through the posterior approach. The Savory technique was used to repair the posterior soft tissue layer. 160 patients had undergone primary arthroplasty and 96 had revision surgery. There were 3 cases of dislocation among the primary arthroplasty cases and 7 among the revision group.

Conclusion: This review showed that posterior approach to the hip continues to be associated with higher dislocation rates than other approaches. Using the Savory technique can reduce the dislocation rate following total hip arthroplasty.