Do Spanish surgeons trust hip stabilizing devices to prevent prosthetic dislocation?

INTRODUCTION: One of the most common complications that can occur after total hip arthroplasty (THA) is dislocation. Prosthetic dislocation is described as one of the main causes of revision surgery. After a first episode most studies conclude that conservative treatment is acceptable. However, there is no consensus on a standardised treatment to help prevent further episodes. The goal of our study was to describe the preferences and reliance in clinical practice of hip-stabilizing devices among Spanish hip surgeons. It was hypothesized that no clear consensus exists among Spanish hip surgeons regarding the use of anti-dislocation devices.

MATERIAL AND METHODOLOGY: The survey was conducted to assess use of orthopaedic immobilisations. A total of eighty-three hip surgeons from hospitals in Spain responded about the volume of THA surgeries, the incidence of dislocation and the use of orthopaedic immobilisation devices after an episode of dislocation.

RESULTS: There were 46% of surgeons who came from medium volume hospitals. The majority were senior surgeons. Up to 42% of the participants did not use any immobilization after the episode. The survey showed some variability among those who used some kind of immobilization orthosis regarding length of immobilization (from less than 2 weeks (14.6%) to more than 6 weeks (15.9%), as well as preference for different types of devices. We found no consensus on the use and trust of the device, for example 33% of surgeons who believed the orthosis ineffective affirmed they continued to use them in their clinical practice.

CONCLUSIONS: There is no consensus on the use of hip stabilizing devices. The survey reveals a very heterogeneous, surgeon and center-dependent use of orthopaedic devices.