What's the Diagnosis? By Dr. Sarab Sodhi
A 62 yo male with a hx of bilateral hip replacements c/o, "I think I dislocated my hip again." Patient rolled out of bed and was unable to walk. An x-ray is shown below. What's the diagnosis? Scroll down for answer.
Answer: Anterior prosthetic hip dislocation
- This hip dislocation is managed with similar prompt reduction techniques as would be a native hip dislocation - click here for a review of hip reduction maneuvers.
- Native hip dislocations are usually due to a high energy mechanism, more comonly posteriorly displaced, and are orthopedic emergencies as avascular necrosis may ensue within 6 hours of dislocation.
- Prosthetic hip dislocations, like this one, are much more common (1-10% incidence). They may be recurrent, and from minor incidents. They are often easier to reduce.
- Unlike those with native hip dislocations, patients with prosthetic hip dislocations may often be safely discharged home post-reduction in consultation with the orthopedic specialist.
Reference: Tintinalli JE, et al. (2016). Chapter 273 Hip and femur injuries. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 8th Ed. New York: McGraw Hill Education.