Radiological factors associated with posterior dislocation after total hip arthroplasty for osteonecrosis of the femoral head - A retrospective study

Kosei Sakamoto; Goro Motomura; Satoshi Hamai; Shinya Kawahara; Taishi Sato; Ryosuke Yamaguchi; Takeshi Utsunomiya; Yasuharu Nakashima

doi:10.1016/j.jor.2023.11.015

Radiological factors associated with posterior dislocation after total hip arthroplasty for osteonecrosis of the femoral head - A retrospective study

J Orthop. 2023 Nov 11:48:38-41. doi: 10.1016/j.jor.2023.11.015. eCollection 2024 Feb.

Authors

Kosei Sakamoto¹, Goro Motomura¹, Satoshi Hamai¹, Shinya Kawahara¹, Taishi Sato¹, Ryosuke Yamaguchi¹, Takeshi Utsunomiya¹, Yasuharu Nakashima¹

Affiliation

¹ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

PMID: 38059215
PMCID: PMC10696299 (available on 2025-02-01)
DOI: 10.1016/j.jor.2023.11.015

Abstract

Purpose: The dislocation rate after total hip arthroplasty for osteonecrosis of the femoral head is higher than that after total hip arthroplasty for osteoarthritis. However, few reports have investigated the factors contributing to dislocation after total hip arthroplasty for osteonecrosis of the femoral head. The aim of this study was to assess radiological factors associated with posterior dislocation after total hip arthroplasty for osteonecrosis of the femoral head.

Methods: We retrospectively reviewed 179 cementless total hip arthroplasties for osteonecrosis of the femoral head using a posterolateral approach between 2002 and 2020 with a minimum follow-up period of 24 months. The following radiological factors were examined for a possible association with posterior dislocation after total hip arthroplasty: cup anteversion angle, cup inclination angle, femoral offset, and stem anteversion angle.

Results: Posterior dislocation occurred in seven hips (3.9 %). Compared to hips without posterior dislocation, those with posterior dislocation exhibited a significantly smaller cup anteversion angle (p = 0.045) and a nonsignificantly greater decrease in femoral offset (p = 0.089). Based on receiver operating characteristic curve analyses, the cutoff values for predicting posterior dislocation were 9.9° for the cup anteversion angle and 8.1 mm for the decrease in femoral offset. Logistic regression analysis showed a significantly higher risk of posterior dislocation among hips with a cup anteversion angle less than 9.9° (odds ratio = 7.1, p = 0.022) or with a decrease in femoral offset over 8.1 mm (odds ratio = 5.0, p = 0.040).

Conclusions: A small cup anteversion angle and a decreased femoral offset are suggested to be associated with posterior dislocation after total hip arthroplasty in patients with osteonecrosis of the femoral head.

Keywords: Cup anteversion; Dislocation; Femoral offset; Osteonecrosis of the femoral head; Total hip arthroplasty.