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Total Hip Arthroplasty Dislocation after Cardioversion: A Case Report.

Ahmed Siddiqi1, Carl T Talmo2, James V Bono2

  • 1Orthopedic Surgery Department, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.

Surgical Technology International
|October 14, 2017
PubMed
Summary
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Postoperative atrial fibrillation (AF) is common in elderly patients after surgery. A rare case shows total hip arthroplasty dislocation after electrical cardioversion for AF.

Area of Science:

  • Cardiology
  • Orthopedic Surgery
  • Anesthesiology

Background:

  • New onset postoperative atrial fibrillation (AF) is a common perioperative arrhythmia in the elderly, though less frequent after total joint arthroplasty compared to other non-cardiac surgeries.
  • Postoperative AF can lead to extended hospital stays, increased mortality, and higher healthcare costs, necessitating effective prevention and management strategies.
  • Current treatment for new onset AF involves rhythm control for hemodynamically unstable or rate-control-refractory patients, with electrical cardioversion being an option for unstable cases.

Observation:

  • Limited data exists regarding orthopedic complications following cardioversion.
  • A unique case involved a patient experiencing total hip arthroplasty (THA) dislocation after electrical cardioversion for new onset AF.
  • This event occurred in the postanesthesia care unit (PACU) following the patient's THA surgery.

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Findings:

  • Electrical cardioversion, while effective for AF, carries a potential risk of orthopedic complications.
  • The reported case highlights a specific orthopedic adverse event—THA dislocation—following cardioversion.
  • This suggests a need for careful consideration of orthopedic status in patients undergoing cardioversion post-THA.

Implications:

  • The findings underscore the importance of considering orthopedic integrity when performing electrical cardioversion in patients with recent joint arthroplasty.
  • Further research is warranted to investigate the incidence and risk factors for orthopedic complications after cardioversion in this patient population.
  • Clinical protocols may need to be updated to include specific precautions for patients with THA undergoing cardioversion to prevent adverse orthopedic events.