High Risk of Venous Thromboembolism With Aspirin Prophylaxis After THA for High-riding Developmental Dysplasia of the Hip: A Retrospective, Comparative Study.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. 9. Bone Joint J. 2025 Oct 1;107-B(10):1004-1010. doi: 10.1302/0301-620X.107B10.BJJ-2024-1637.R1. The cumulative incidence of dislocation and revision surgery following total hip arthroplasty for hip fracture in New South Wales : a data linkage study. Farey JE(1)(2), Li A(3), Adie S(4), Smith PN(5)(6), Lujic S(3), Harris IA(1)(5). Author information: (1)Institute for Musculoskeletal Health, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia. (2)Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York City, New York, USA. (3)Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. (4)St George and Sutherland Clinical School, University of New South Wales, St. George Hospital, Sydney, Australia. (5)Australian Orthopaedic Association National Joint Replacement Registry, South Australian Health and Medical Research Institute, Adelaide, Australia. (6)Australian National University Medical School, The Canberra Hospital, Canberra, Australia. AIMS: Dislocation is a common problem after total hip arthroplasty (THA) for hip fracture. This study aimed to assess the one-year cumulative incidence of dislocation, and identify associated risk factors. METHODS: An observational cohort study was conducted using data from the Australian Orthopaedic Association National Joint Replacement Registry linked with the New South Wales Admitted Patient Data Collection. Patients aged over 18 years who underwent THA for fracture neck of femur between 1 July 2010 and 31 December 2018 in New South Wales were included. Dislocations and revision surgeries were identified via linked datasets. Multivariable logistic regression evaluated demographic, surgical, and implant-related risk factors for dislocation. Subgroup analysis considered surgical approach and BMI. RESULTS: Among 4,632 patients, the one-year dislocation incidence was 4.8% (95% CI 4.2 to 5.5), with 79% occurring within 90 days. Revision for dislocation occurred in 1.1% of cases (95% CI 0.80 to 1.4). Compared with dual-mobility acetabular components, conventional bearings ≤ 32 mm (odds ratio (OR) 1.64 (95% CI 0.93 to 2.90); p = 0.087) and > 32 mm (OR 1.33 (95% CI 0.75 to 2.37); p = 0.332) showed no significant difference in dislocation risk. In a subgroup of 2,532 patients, the anterior approach significantly reduced dislocation risk (OR 0.28 (95% CI 0.12 to 0.67); p = 0.004), whereas the lateral approach did not (OR 0.75 (95% CI 0.48 to 1.17); p = 0.202) compared to the posterior approach. Adjusting for surgical approach, ≤ 32 mm bearings were associated with a higher dislocation risk than dual-mobility components (OR 1.97 (95% CI 1.06 to 3.66); p = 0.031); > 32 mm bearings were not significantly different (OR 1.68 (95% CI 0.89 to 3.15); p = 0.110). CONCLUSION: One in 20 patients undergoing THA for fracture will experience dislocation within a year, though most will not require revision. Dual-mobility components may be protective against dislocation compared with smaller-diameter femoral head sizes. © 2025 The British Editorial Society of Bone & Joint Surgery. DOI: 10.1302/0301-620X.107B10.BJJ-2024-1637.R1