From the Research
The most common cause of posterior dislocation of a Total Hip Replacement (THR) is noncompliance with recommended hip positioning, as highlighted in a recent study 1. This cause is closely related to patient-related risk factors, including poor compliance with hip precautions, muscle weakness, previous hip surgery, and certain implant positioning issues such as inadequate anteversion of the acetabular component. Some key points to consider in preventing posterior dislocations include:
- Avoiding hip flexion beyond 90 degrees
- Avoiding internal rotation and adduction
- Using elevated toilet seats and chairs
- Utilizing assistive devices for putting on shoes and socks without excessive bending A recent study 1 found that posterior dislocations were the most common type, occurring in 60% of cases, and that noncompliance with recommended hip positioning was the main cause of dislocation. Another study 2 found that increased age, ASA score, and larger acetabular cup size were associated with a heightened risk of dislocation, and that tendon-to-bone repair without posterior precautions may be a recommended approach for reducing dislocation rates. However, the most recent and highest quality study 1 suggests that noncompliance with recommended hip positioning is the most common cause of posterior dislocation, and therefore, patient education and adherence to postoperative precautions are crucial in preventing this complication.