Discussion
obesity, including neuromuscular disease, femoral neck fractures, dislocation
OBESITY, DISC DEGENERATIVE DISEASE, COMPLICATIONS
We found that mesh reconstruction was associated with a higher rate of posterior capsule integrity and a lower rate of hip dislocation than capsular repair after primary arthroplasty. Our findings suggest that mesh reconstruction provides significant functional benefits and good survival in patients with a high risk of dislocation. What is more gratifying is that mesh reconstruction has not increased the incidence of complications. Compared to capsular repair, mesh reconstruction is relatively complex and takes an additional 12 min to complete. It increases the cost of the treatment but is acceptable.Previous studies have shown that retention and reconstruction of the hip capsule can significantly reduce the rate of dislocation after primary THA. Pellicci et al. [In the method we present, mesh was used to reconstruct the capsule while playing a fundamental role in balancing functional mobility and joint stability, such as ischiofemoral ligament [Mesh reconstruction is indicated in patients with a high risk of hip dislocation, including neuromuscular disease, degenerative disc disease, lumbosacral fusion, obesity, higher preoperative activity, and poor muscle strength [Mesh reconstruction has advantages. First, the mesh is made from a synthetic polymer material with high strength and good tissue compatibility. Therefore, the reconstruction is stronger than capsular repair and achieves early hip stability. Second, the mesh is located at the posterior aspect of the hip, between the pelvis and the proximal end of the femur, forming a barrier to prevent posterior dislocation. Third, the mesh will twist and tighten to act as a “tension band” and an orbicularis band when the hip flexion is large. Fourth, full range of motion of the hip can be preserved. The disadvantages are the additional time and cost needed. Despite increased time and cost, the decrease in dislocation rates is clinically important, and the benefits of the procedure exceed the disadvantages.This study has limitations. First, the small sample size produces statistical bias, and the patients with femoral neck fractures led to a high postoperative dislocation rate. Second, the follow-up time was short, and hip function improved over time, even though hip dislocation mostly occurred 120 days after surgery [