PubMed · 257265
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J Fraser. 1979. Trauma quiz (hip dislocation).. https://pubmed.ncbi.nlm.nih.gov/257265/
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Posterior hip dislocation is a common complication after total hip replacement. Some authors recommend repair of the short external rotator tendons to stabilize the hip joint postoperatively. We evaluated the efficacy of repair of the piriformis tendon in 10 consecutive total hip replacement cases. Eight of the 10 repairs failed during the early postoperative period, and one of the two repairs that did not fail was in the only patient to sustain a posterior dislocation. We believe that repair of the piriformis tendon is of no significant benefit to the stability of a total hip replacement joint.
The most statistically significant risk factors for hip dislocations following total hip arthroplasty include prior hip surgery, trochanteric nonunion, and posterior surgical approach. Reoperation is required in only about one third of those patients who sustained dislocations. The most reliable surgical procedure is reorientation of the retroverted acetabular component. Care should be exercised to define the precise cause of the instability to plan the surgery that best addresses this particular problem.