Open Access Open Access  Restricted Access Subscription Access

Risk forecasting of the femoral head dislocation and its prophylaxis at total hip joint replacement

Volodymyr Filipenko, Vera Kolesnichenko, Volodymyr Mezentsev, Oleh Ovchynnikov


One of the most frequent complications after total hip replacement is femoral head dislocation. Risk of its forecasting is topical in orthopeadic field.

Objective: on the base of retrospective and prospective analysis we wanted to define the quantitative criteria of risk forecasting and to work out the method of dislocation prophylaxis after total hip replacement.

Methods: retrospective analysis of clinical and roentgenological examination of 80 patients after total hip replacement was conducted. Neutral cup liner was used. Quantitative criteria of risk forecasting were made with consistent forecast procedure. Prospective study of replacement results was made. We used author’s method — liner with visor — 24 patients (11 men, 13 women, average age (55.0 ± 18.4) years old).

Results: the risk factors of the femoral head dislocation are: overweight (82,5 %), muscles weakness in the region of the hip joint (67,5 %), age older than 61 years old (52,5 %), non-compliance of orthopaedic mode in the postoperative period (50,0 %). Computational table was worked out in order to forecast the risk of the femoral head dislocation. We suggest the method of prophylaxis and the treatment with certain position of implant components and the usage of liner with visor.

Conclusions: on the base of retrospective analysis of clinical and roentgenological assessment we could reveal the risk factors of femoral head instability after THR. The most significant forecast signs were oversized movements in the hip joint (I = 1.44), femoral head diameter less than 32 mm (I = 0 .50), age older than 61 years old ( I = 0 .47). Favorable result of the surgery was due to 10° cup liner.


hip joint, replacement; femoral head dislocation; liner with visor; prophylaxis; forecast


Gayko, G. V., Gerasimenko, S. І., Polulyach, M. V., & Torchinsky, V.P. (2006). Condition and prospects of joints endoprosthetics, Theses of the XIV Congress of Orthopedic-Traumatologists of Ukraine (pp. 423-425), Odessa. (in Russian)

Philippenko, V. A., & Tankut, V. A. (2009). Evolution of the problem of joints arthroplasty. International Medical Journal, 15, № 1(57),70–74. (in Russian)

Havelin, L. I., Robertsson, O., Fenstad, A. M., Overgaard, S., Garellick, G., & Furnes, O. (2011). A scandinavian experience of register collaboration: The Nordic Arthroplasty Register Association (NARA). The Journal of Bone and Joint Surgery-American Volume, 93 (Suppl 3), 13-19. doi:10.2106/jbjs.k.00951

Zagorodny, N. V. (2012). Arthroplasty of the hip joint. Fundamentals and practice (pp. 503-545). Мoscow, M: GEOTAR-Media. (in Russian)

Hooper, G. (2013). The ageing population and the increasing demand for joint replacement. The New Zealand Medical Journal, 126(1377), 5–6.

Maloney, W. J. (2007). Dislocation of the implant head, Proceedings of annual meeting of AAOS.

Conroy, J. L., Whitehouse, S. L., Graves, S. E., Pratt, N. L., Ryan, P., & Crawford, R. W. (2008). Risk factors for revision for early dislocation in total hip arthroplasty. The Journal of Arthroplasty, 23 (6), 867-872. doi:10.1016/j.arth.2007.07.009.

Werner, B. C. (2012). Instability after total hip arthroplasty. World Journal of Orthopedics, 3(8), 122. doi:10.5312/wjo.v3.i8.122

Herasymenko, S. I., Poluliakh, M. V., Roi, I. V., Herasymenko, A. S., Pavlova, Yu. H., Zamorskyi, T.V., & Kudrin, A. P. (2015). Prevention of dislocation of the femoral component of endoprosthesis after total hip joint arthroplasty in patients with rheumatoid arthritis. Trauma. 16, № 6, 55–58. (in Ukrainian)

Biedermann, R. C., Tonin, A., Krismer, M., Rachbauer, F., Eibl, G., & Stöckl, B. (2005). Reducing the risk of dislocation after total hip arthroplasty. The Journal of Bone and Joint Surgery. British volume, 87-B(6), 762-769. doi:10.1302/0301-620x.87b6.14745

Filipenko, V., Tankut, V., Tankut, O., & Zhygun, A. (2010). Complications of hip-joint arthroplasty. Orthopaedics, Traumatology and Prosthetics, 2, 11-16. doi: (in Russian)

Peters, C. L., McPherson, E., Jackson, J. D., & Erickson, J. A. (2007). Reduction in early dislocation rate with large-diameter femoral heads in primary total hip arthroplasty. The Journal of Arthroplasty, 22 (6 Suppl. 2), 140–144. doi:10.1016/j.arth.2007.04.019

Vakulenko, V. M., Vakulenko, A.V., & Nedelko, А. А. (2014). Dislocation after total hip arthroplasty. Trauma, 15, № 3, 47–55. (in Russian)

Tyhylov, R. M., Shapovalov, V. M. (2008). Guide hip arthroplasty (pp. 259–262). St. Petersburg, SPb: RNIITO. (in Russian)

Jameson, S. S., Lees, D., James, P., Serrano-Pedraza, I., Partington, P. F., Muller, S. D., … Reed, M. R. (2011). Lower rates of dislocation with increased femoral head size after primary total hip replacement. The Journal of Bone and Joint Surgery. British volume, 93-B(7), 876-880. doi:10.1302/0301-620x.93b7.26657

Merle, C., Grammatopoulos, G., Waldstein, W., Pegg, E., Pandit, H., Aldinger, P. R., … Murray, D. W. (2013). Comparison of native anatomy with recommended safe component orientation in total hip arthroplasty for primary osteoarthritis. The Journal of Bone & Joint Surgery, 95(22), e172. doi:10.2106/jbjs.l.01014

Gayko, G. V., Torchynsky, V. P., Sulima, О. М., Pidgayetsky, V. M., Osadchuk, T. I., Kalashnikov, O. V., Nizalov, T. V., Galuzynsky, A. A., & Kozak, R. A. (2014). Mistakes and complications of revision arthroplasty in patients with aseptic loosening of the acetabular component of femoral endoprosthesis. Тrauma,15 (1), 74–77. (in Ukrainian)

Qassem, D. M., & Smith, K. B. (2004). Effect of elevated-rim acetabular liner and 32-mm femoralhead on stability in total hip arthroplasty. Saudi Medical Journal, 25(1), 88–90.

Krushell, R. J., Burke, D. W., & Harris, W. H. (1991). Elevated-rim acetabular components. The Journal of Arthroplasty, 6, S53-S58. doi:10.1016/s0883-5403(08)80056-3

Cobb, T. K., Morrey, B. F., & Ilstrup, D. M. (1996). The elevated-rim acetabular liner in total hip arthroplasty. The Journal of Bone & Joint Surgery, 78(1), 80-6. doi:10.2106/00004623-199601000-00011

Cobb, T. K., Morrey, B. F., & Ilstrup, D. M. (1997). Effect of the elevated-rim acetabular liner on loosening after total hip arthroplasty. The Journal of Bone and Joint Surgery (American Volume), 79(9), 1361-1364. doi:10.2106/00004623-199709000-00010

Sultan, P., Tan, V., Lai, M., & Garino, J. (2002). Independent contribution of elevated-rim acetabular liner and femoral head size to the stability of total hip implants. The Journal of Arthroplasty, 17(3), 289-292. doi:10.1054/arth.2002.30415

Loskutov, А. Е., Oleinyk, А. Е. (2006). Hip joint arthroplasty: Achievements and prospects. Diagnosis and treatment, № 1–2, 136–140. (in Russian)

Nadeev, А. А., & Ivannikov, S. V. (2006). Hip endoprostheses in Russia: Construction philosophy, implant overview, rational choice. Мoscow: BINOM. Knowledge lab. (in Russian)

Furmanski, J., Anderson, M., Bal, S., Greenwald, A. S., Halley, D., Penenberg, B., … Pruitt, L. (2009). Clinical fracture of cross-linked UHMWPE acetabular liners. Biomaterials, 30(29), 5572-5582. doi:10.1016/j.biomaterials.2009.07.013

Philippenko, V. A., Tankut, V. O., Mezentsev, V. O., Ovchinnikov, O. M. (2017). Causes of dislocation of the endoprosthesis head after primary hip arthroplasty. Тrauma, 18 (1), 27–33. (in Ukrainian)

Gubler, E. V. (1978). Computational methods of analysis and recognition of pathological processes. Мoscow: Medicine. (in Russian)

Pokrovsky, V. I., & Briko, N. I. (2012). General epidemiology with the basics of evidence-based medicine. A guide to practical exercises. Мoscow: GEOTAR-Media. (in Russian)



  • There are currently no refbacks.

Copyright (c) 2018 Volodymyr Filipenko, Vera Kolesnichenko, Volodymyr Mezentsev, Oleh Ovchynnikov

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.