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Recurrent and radiographically unrecognized iatrogenic intra-prosthesis hip dislocations
Olivia J K Fox1, Stephanie L Cairns2, Paul G Jarman2
1School of Medicine University of Notre Dame Darlinghurst New South Wales Australia.
Journal of the American College of Emergency Physicians Open
|October 1, 2020
Summary
A novel dual mobility hip implant can dislocate within the prosthesis itself, a complication missed in emergency settings. Awareness of this specific prosthetic hip dislocation is crucial for emergency physicians.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Emergency medicine
Background:
- Total hip arthroplasty (THA) is a common procedure to address hip joint damage.
- Post-surgical hip dislocation remains a significant complication, impacting patient outcomes.
- Advancements in prosthetic implant design aim to minimize dislocation risks.
Observation:
- A new dual mobility hip implant presents a unique design.
- This design carries a risk of intra-prosthetic dislocation, distinct from typical hip dislocation.
- A case series highlights recurrently missed iatrogenic intra-prosthetic dislocations in the emergency department (ED).
Findings:
- The dual mobility implant's specific geometry can lead to dislocation within the implant components.
- Closed reduction attempts in the ED may fail to recognize or address intra-prosthetic dislocation.
- Misdiagnosis can result in delayed or inappropriate management of these specific hip implant complications.
Implications:
- Emergency physicians require specialized knowledge of dual mobility implant designs.
- Understanding the potential for intra-prosthetic dislocation is critical for accurate diagnosis.
- Improved diagnostic protocols and physician education are needed for managing complications associated with novel hip prosthetics.
