Influence of surgical approach on dislocations after Charnley hip arthroplasty.

Dislocations occurring in 3,199 Charnley total hip arthroplasties in two orthopaedic centers between 1979 and 1991 performed by either the transtrochanteric or posterior approach were studied. The incidence of dislocation within 2 years of surgery (2.8%), as well as the overall frequency (3.4%), did not differ between the two centers. Regardless of approach, there was a higher risk of dislocations for patients with osteoarthrosis. A logistic regression analysis, reflecting the differences in preoperative hip diagnoses and sex, indicated that the dislocation rate was not influenced by the surgical approach. More early dislocations were documented after the posterior approach, but without increases in the rates of recurrence or revision. Arthroplasties performed by less experienced surgeons through the posterior approach resulted in more dislocations.