Posterior approach increases the risk with Dislocation of he
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Reported revision rates due to dislocation after hemiarthroplasty span a wide range. Dislocations treated with closed reduction are rarely reported despite the fact that they can be expected to constitute most of the dislocations that occur. Researchers aimed to describe the total dislocation rate on the national level, and to identify risk factors for dislocation.

Researchers co-processed a national cohort of 25,678 patients in the Swedish Hip Arthroplasty Register, with the National Patient Register (NPR) and Statistics Sweden. Dislocation was defined as the occurrence of any ICD-10 or procedural code related to hip dislocation recorded in the NPR, with a minimum of 1-year-follow-up.

Results:
--366/13,769 patients operated on with direct lateral approach dislocated, compared with 850/11,834 of those with posterior approach.

--Posterior approach was the strongest risk factor for dislocation (OR = 2.7), followed by dementia (OR = 1.3). The older the patients, the lower the risk of dislocation (OR = 0.98 per year of age).

--Neither bipolar design nor cementless stems influenced the risk.

Finally, the posterior approach and dementia were also linked to a higher risk of dislocation. When hips treated with closed reduction were detected, the incidence of dislocation using the direct lateral and posterior approaches more than doubled and tripled, respectively, when compared to revisions due to dislocation.

Source: https://www.tandfonline.com/doi/full/10.1080/17453674.2021.1906517?af=R
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