Four Soft Tissue Repair Methods On Early Replacement Of Primary Posterior Dislocation After Total Hip

Background:Since1938, Dr Wiles successfully complete the first Total Hip Arthroplasty operation. With the progress of the concept of the hip disease treatment, biology, material of hip prosthesis, manufacture and installation, the THA gradually become the standard treatment for the end phase of the hip osteoarthritis.How to prevent postoperative dislocation after total hip replacement continues to be the focus of attention. The study retrospectively analyzed the early postoperative dislocation rate of primary total hip replacement with capsuloteadinous and external rotation muscle repair,and compared witll the resultt of primary total hip replacements without capsulotendinous and external rotation muscle repair, only repair the external muscle with tendon and only repair the external muscle with bone. Our objective is not only to explore the feasibility of this repair method in total hip replacement, but also to investigate whether the repair method can reduce postoperative dislocation rate and its possible mechanism.Objective:Compare with these four methods’ dislocation rate to determine whether the posterior soft tissue structures repair skill affects dislocation rate.Methods:We retrospectively analyzed the cases of THA in our joint center from January2008to Sep2011. We exclude all the other interference factors like approach prosthesis、installation and so on.We bring436patients,552hips in our research.All these prosthesis are metal or ceramic to polyethylene, choose the posterior approach.140cases with no repairment.104cases only repair the external muscle with tendon,213cases only repair the external muscle with bone and65cases of THA with posterior capsuletendinous and short external rotators repair, and the duration of follow-up is at least6months.Results:In patients with posterior capsular and short external rotators repair,0hip with primary total hip replacement(0%)underwent early dislocation. In patients without posterior capsulotendinous and short external rotators repair,the early dislocation rate is6.43%. The dislocation rate of the repair with tendon group is4.8%, another group’s rate is3.29%.It is difference between the first two groups was statistically significan (X=3.96,P=0.047<0.05). There is no significant difference in any other comparement between two groups.Conclusions:Repair posterior capsulotendinous and short external rotators can effectively prevent postoperative early dislocation.