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Successful closed reduction of a dislocated constrained total hip arthroplasty: a case report and literature review.

Sonohata M, Waewsawangwong W, Goodman SB - Open Orthop J (2012)

Bottom Line: The success rate and clinical results of closed reduction for such patients is unclear.This report presents a case of a successful closed reduction of a dislocated constrained liner.Publication of additional successful and unsuccessful case reports is therefore needed to help establish the optimal treatment protocol for a dislocated constrained liner.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Stanford School of Medicine, Stanford University, Stanford, California, USA.

ABSTRACT
Many surgeons use acetabular components with constrained polyethylene liners to improve stability after total hip arthroplasty in patients with a history of hip dislocation. Surgical treatment is generally thought to be the only available option for the dislocated constrained liner. The success rate and clinical results of closed reduction for such patients is unclear. This report presents a case of a successful closed reduction of a dislocated constrained liner. Few papers have so far addressed closed reduction of a dislocated constrained liner. Furthermore, previous studies reported a variety of components. Publication of additional successful and unsuccessful case reports is therefore needed to help establish the optimal treatment protocol for a dislocated constrained liner.

No MeSH data available.


Related in: MedlinePlus

Radiographs before dislocation. (A) Anteroposterior view, (B) Lateral view.
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Figure 2: Radiographs before dislocation. (A) Anteroposterior view, (B) Lateral view.

Mentions: A 79-year-old female underwent primary THA for nonunion of a right subtrochanteric fracture of the femur with degenerative arthritis of the right hip joint using an uncemented Trilogy acetabular system and fully porous-coated stem (Zimmer, Warsaw, Indiana, USA). Five years later, at age 84, the hip was revised to a Trilogy constrained liner with a 10-degree oblique face and 32-mm head (Zimmer, Inc, Warsaw, Indiana, USA) (Fig. 1) for instability and recurrent dislocation (Fig. 2). However, 5 years after the revision surgery, at age 88, she bent over, hyperflexed the hip and complained of right hip pain. A radiograph in the emergency department in our hospital demonstrated dislocation of the constrained THA. The head appeared to have dislocated from the liner, and the locking ring disengaged but was not broken (Fig. 3). A closed reduction was performed in the emergency department with sedation. The head was relocated and the locking ring was repositioned to where it was previously located (Fig. 4). The patient’s hip was placed in an abduction brace with full weight bearing. Further radiographs demonstrated no further change. The patient could ambulate with minimal aid. The patient died 10 months later of unrelated causes.


Successful closed reduction of a dislocated constrained total hip arthroplasty: a case report and literature review.

Sonohata M, Waewsawangwong W, Goodman SB - Open Orthop J (2012)

Radiographs before dislocation. (A) Anteroposterior view, (B) Lateral view.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3367303&req=5

Figure 2: Radiographs before dislocation. (A) Anteroposterior view, (B) Lateral view.
Mentions: A 79-year-old female underwent primary THA for nonunion of a right subtrochanteric fracture of the femur with degenerative arthritis of the right hip joint using an uncemented Trilogy acetabular system and fully porous-coated stem (Zimmer, Warsaw, Indiana, USA). Five years later, at age 84, the hip was revised to a Trilogy constrained liner with a 10-degree oblique face and 32-mm head (Zimmer, Inc, Warsaw, Indiana, USA) (Fig. 1) for instability and recurrent dislocation (Fig. 2). However, 5 years after the revision surgery, at age 88, she bent over, hyperflexed the hip and complained of right hip pain. A radiograph in the emergency department in our hospital demonstrated dislocation of the constrained THA. The head appeared to have dislocated from the liner, and the locking ring disengaged but was not broken (Fig. 3). A closed reduction was performed in the emergency department with sedation. The head was relocated and the locking ring was repositioned to where it was previously located (Fig. 4). The patient’s hip was placed in an abduction brace with full weight bearing. Further radiographs demonstrated no further change. The patient could ambulate with minimal aid. The patient died 10 months later of unrelated causes.

Bottom Line: The success rate and clinical results of closed reduction for such patients is unclear.This report presents a case of a successful closed reduction of a dislocated constrained liner.Publication of additional successful and unsuccessful case reports is therefore needed to help establish the optimal treatment protocol for a dislocated constrained liner.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Stanford School of Medicine, Stanford University, Stanford, California, USA.

ABSTRACT
Many surgeons use acetabular components with constrained polyethylene liners to improve stability after total hip arthroplasty in patients with a history of hip dislocation. Surgical treatment is generally thought to be the only available option for the dislocated constrained liner. The success rate and clinical results of closed reduction for such patients is unclear. This report presents a case of a successful closed reduction of a dislocated constrained liner. Few papers have so far addressed closed reduction of a dislocated constrained liner. Furthermore, previous studies reported a variety of components. Publication of additional successful and unsuccessful case reports is therefore needed to help establish the optimal treatment protocol for a dislocated constrained liner.

No MeSH data available.


Related in: MedlinePlus