Table of ContentsView AllTable of ContentsDislocationsSignsRisk FactorsWhen to Seek TreatmentDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Dislocations
Signs
Risk Factors
When to Seek Treatment
Diagnosis
Treatment
Prevention
Among the most frequently seen complications of hip replacement surgery is dislocation of the hip replacement.Hip replacement dislocationsoccur in about 4% of first-time surgeries and about 15% of revision hip replacements. This complication is uncommon, but it does occur—sometimes in unforeseen circumstances.
A dislocated hip replacement is considered a medical emergency. If you suspect that your replacement may be dislocated you should seek medical treatment.
This article takes you through the risk factors, symptoms, diagnosis, and treatment options for a hip replacement dislocation, as well as some preventative steps to avoid this complication.
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An Overview of Hip Replacement Surgery
Dislocations of Hip Replacements
Normal hip joints have many surrounding structures that help to stabilize the hip joint. These structures include muscles, ligaments, and the normal bony structure of the hip joint. Together, these structures keep the ball (the femoral head) within the socket (theacetabulum).
When the hip replacement surgery is performed, the hip can become less stable.By losing some of these stabilizing hip structures, the metal and plastic hip replacement can, in some cases, be prone to coming out of joint, or dislocating.
People who have a hip replacement may be instructed to takehip precautions. Hip precautions are various maneuvers a patient who has undergone a hip replacement needs to avoid and are based on the type of surgery they had. These physical activities place the hip joint in a position where the ball could fall out of the socket.
Hip PrecautionsPosterior hip precautions include the following:Do not cross your legs.Do not bend your legs up beyond 90 degrees.Do not sit on sofas or in low chairs.Do not sleep on your side.
Hip Precautions
Posterior hip precautions include the following:Do not cross your legs.Do not bend your legs up beyond 90 degrees.Do not sit on sofas or in low chairs.Do not sleep on your side.
Posterior hip precautions include the following:
Most physicians ease these precautions after rehabilitation, but total hip replacements can be less stable than normal hips even years after surgery.
Signs of a Dislocated Hip Replacement
A dislocated hip replacement is painful and you will very likely be unable to bear weight on the affected leg.
If you have engaged in any of the hip precaution behaviors listed above, or have had a fall or other impact injury (such as from a car accident) and your hip is very painful, you should contact yourorthopedic surgeonright away or go to an emergency department.
Risk Factors for Dislocated Hip Replacement
Sometimes hip replacements are more prone to dislocation. Factors that can contribute to hip replacement dislocations include:
In some circumstances, patients have no identifiable cause for sustaining adislocationof their hip replacement.
When to See a Healthcare Provider
A dislocated hip replacement is a medical emergency. People suffering from a hip dislocation will know immediately that something has gone wrong with their implant. Any movement or effort at weight bearing will be painful and difficult.
Medical treatment should be sought as soon as possible.
Diagnosing a Dislocated Hip Replacement
Typical clinical signs of dislocation include:
If a replacement dislocation is suspected, an orthopedist will do a physical exam and order an X-ray to confirm that diagnosis. Sometimes anMRIor aCT scanmay be needed.
Treating a Dislocated Hip Replacement
Hip replacement dislocation treatment depends on several factors. The first step is usually to reposition the hip joint.
This procedure, called a reduction of the hip replacement, is performed under anesthesia—either light sedation in the emergency room orgeneral anesthesiain the operating room.During the procedure, your orthopedic surgeon will pull on the leg to reposition the hip within the socket.
Most often the hip “pops” back into position. Pain relief is almost immediate after the hip implants have been repositioned. X-rays will be obtained to ensure the hip is repositioned and to see if there is any identifiable reason for the dislocation.
If multiple dislocations occur, surgery may be necessary to prevent further dislocations. The implants can be repositioned, or special implants can be used to try to prevent dislocations. You will need to discuss with your orthopedic surgeon the cause of your dislocation and what treatments are available for the problem.
New Prevention Approaches
Recent developments in the design of hip replacement implants and the surgical technique of performing a hip replacement may also lower the chance of developing this complication. Implant design can be changed to create a more stable implant.
Implant Design
The most common design changes of implants that help prevent dislocation include:
Changes in implant design need to be approached with caution, as there can be problems with newer implants, which may not have a long track record of use in patients. While these implants may lower the chance of dislocation, you’ll also want to be sure they don’t cause other problems.
There have been some high-profile implant recalls affecting implants that were specifically designed to last longer with less chance of dislocation. Ultimately, these implants were unfortunately shown to be less successful.
Anterior Approach
Anterior approach hip replacementis a surgery performed to minimize the trauma to some of the structures that stabilize the hip joint. Many surgeons feel that the risk of dislocation may be lower after this surgery compared to a traditional posterior hip replacement.
As a result of a lower likelihood of dislocation after anterior hip replacement, often surgeons will recommend against, or provide alternatives to, hip precautions.
Summary
Hip dislocation can be a major complication of total hip replacement surgery and is considered a medical emergency. Fortunately, the chance of dislocation after hip replacement is small, but when it does occur, additional surgical intervention may be required. Minimizing the risk of this complication can be accomplished with certain precautions and the use of specialized implants and surgical techniques.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dargel J, Oppermann J, Brüggemann GP, Eysel P.Dislocation following total hip replacement.Dtsch Arztebl Int. 2014;111(51-52):884-90. doi:10.3238/arztebl.2014.0884Jones SA.The prevention and treatment of dislocation following total hip arthroplasty: efforts to date and future strategies.Hip Int.2015 Jul-Aug;25(4):388-92. doi:10.5301/hipint.5000273Kunutsor SK, Barrett MC, Beswick AD, et al.Risk factors for dislocation after primary total hip replacement: meta-analysis of 125 studies involving approximately five million hip replacements.Lancet Rheumatol. 2019;1(2):e111-e121. doi:10.1016/s2665-9913(19)30045-1Medmastery.How to diagnose a prosthetic hip dislocation.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dargel J, Oppermann J, Brüggemann GP, Eysel P.Dislocation following total hip replacement.Dtsch Arztebl Int. 2014;111(51-52):884-90. doi:10.3238/arztebl.2014.0884Jones SA.The prevention and treatment of dislocation following total hip arthroplasty: efforts to date and future strategies.Hip Int.2015 Jul-Aug;25(4):388-92. doi:10.5301/hipint.5000273Kunutsor SK, Barrett MC, Beswick AD, et al.Risk factors for dislocation after primary total hip replacement: meta-analysis of 125 studies involving approximately five million hip replacements.Lancet Rheumatol. 2019;1(2):e111-e121. doi:10.1016/s2665-9913(19)30045-1Medmastery.How to diagnose a prosthetic hip dislocation.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Dargel J, Oppermann J, Brüggemann GP, Eysel P.Dislocation following total hip replacement.Dtsch Arztebl Int. 2014;111(51-52):884-90. doi:10.3238/arztebl.2014.0884Jones SA.The prevention and treatment of dislocation following total hip arthroplasty: efforts to date and future strategies.Hip Int.2015 Jul-Aug;25(4):388-92. doi:10.5301/hipint.5000273Kunutsor SK, Barrett MC, Beswick AD, et al.Risk factors for dislocation after primary total hip replacement: meta-analysis of 125 studies involving approximately five million hip replacements.Lancet Rheumatol. 2019;1(2):e111-e121. doi:10.1016/s2665-9913(19)30045-1Medmastery.How to diagnose a prosthetic hip dislocation.
Dargel J, Oppermann J, Brüggemann GP, Eysel P.Dislocation following total hip replacement.Dtsch Arztebl Int. 2014;111(51-52):884-90. doi:10.3238/arztebl.2014.0884
Jones SA.The prevention and treatment of dislocation following total hip arthroplasty: efforts to date and future strategies.Hip Int.2015 Jul-Aug;25(4):388-92. doi:10.5301/hipint.5000273
Kunutsor SK, Barrett MC, Beswick AD, et al.Risk factors for dislocation after primary total hip replacement: meta-analysis of 125 studies involving approximately five million hip replacements.Lancet Rheumatol. 2019;1(2):e111-e121. doi:10.1016/s2665-9913(19)30045-1
Medmastery.How to diagnose a prosthetic hip dislocation.
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