Protection of quadratus femoris and posterior soft tissue repair for the prevention of early dislocation in total hip arthroplasty through posterolateral approach

Shi Si-feng; Lu Wen-hai; Zhou Bing; Chen Xiang-yang; Zhao Feng-chao; Guo Kai-jin

doi:10.3969/j.issn.2095-4344.2016.48.003

Abstract：BACKGROUND:Dislocation after total hip arthroplasty is one of major complications. It is controversial whether posterior soft tissue repair should be carried out during total hip arthroplasty through posterolateral approach and few literatures focus on the protection of quadratus femoris. <br> OBJECTIVE:To explore the effects of quadratus femoris protection and posterior soft tissue repair for the prevention of early dislocation in total hip arthroplasty through posterolateral approach. <br> METHODS:Clinical data of 326 patients from Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University with primary total hip arthroplasty through posterolateral approach from January 2013 to August 2015 were retrospectively analyzed. According to different strategies of soft tissue management, they were assigned to two groups:observation group (187 patients) and control group (139 patients). Protection of quadratus femoris and posterior soft tissue repair was carried up in observation group. Control group did not receive posterior soft tissue repair and quadratus femoris was partial y damaged. Early dislocation was defined as the dislocation occurred within 3 months after operation. Effects of the two methods on early dislocation were compared after arthroplasty. <br> RESULTS AND CONCLUSION:There was one patient with dislocation in observation group (1/187, 0.5%) in the observation group and five patients with dislocation (5/139, 3.6%) in the control group. Dislocation rate was significantly higher in the control group than in the observation group (P<0.05). Results <br> suggested that in primary total hip arthroplasty through posterolateral approach, protection of quadratus femoris and posterior soft tissue repair wil reduce early dislocation rate. Protection of quadratus femoris may play a role in keeping the balance of the soft tissue around the hip joint.