Revizinių klubo sąnario endoprotezavimo (RKSE) operacijų, atliktų dėl šlaunikaulinio komponento išnirimų, analizė. Lietuvos sąnarių endoprotezavimo registro duomenys. ; Analysis of revisions operations performed due to dislocation after total hip arthroplasty. Results from Lithuanian arthroplasty register

The aim of the thesis: To analyse revisions operations performed due to dislocation after total hip arthroplasty in Lithuania. Objectives: 1. Estimate risk factor for dislocation. 2. Investigate the causes of re-revisions operations. 3. Compare re-revision rate between dual-mobility cups and other surgical options after total hip revision performed due to dislocation. Methods: Data were derived from the Lithuanian Arthroplasty Register, we estimated risk factor for revision and calculated the cumulative re-revision rates after surgery. For survival analysis, we used re-revision for all reasons and for dislocations as an end-point. Cox proportional hazards models were used to analyze the influence of various covariates (age, gender, diagnosis of primary operation and implant concept). Results: The biger relative risk (RR) due to dislocation has 70 years and older patients RR 1,7 (95% confidence intervals (CI): 1,2-2,3; p=0,002), posterior aproach RR 4,6 (95% CI: 2,5-8,8; p=0,001) primary diagnosis of femural neck fracture RR 4,7 (95% CI: 3,4-6,5; p=0,001) compared with younger that 70 years old patients, lateral aproach and primary diagnosis of primary arthrosis. A total of 1,388 revisions were recorded from 2011 to 2016, of which 362 were performed due to recurrent dislocation. Out of 362 revisions, 247 were performed using dual-mobility cups, while others were operated using a variety of other surgical options including conventional cup, stem, femoral head exchange or anti-luxation ring. 27 patients had been re-revised for the following reasons: dislocations - 15, infections - 7, periprosthetic fractures - 3, and cup loosening - 2. Cox regression adjusting for age, gender and diagnosis of primary operation showed that the use of dual-mobility cup had 7 times (95% CI: 1.8-27.5, p=0.005) lower risk of revision due to dislocation and 3 times lower risk of revision for all reasons (95% CI 1.3-7.3, p=0.011) as compared with other surgical options. Interpretation: 1. 70 years and older, posterior aproach and primary ...