Dislocation after total hip replacement
The incidence of hip dislocation in total hip replacements ranges from 1% to 15% according to various publications. Different factors can cause prosthetic hip dislocation, such as poor orientation of the components, insufficient neo-capsule, conflict between the bony structures, soft tissue tension, generalised muscle weakness with gluteal insufficiency, etc. A bad choice of implant, patient age or medial fractures are usually the most likely triggering factors. Hip arthroplasty is mainly performed due to the presence of coxarthrosis or hip fractures. Two thirds of dislocations are successfully resolved noninvasively, the rest require surgical revision. Factors such as gender (female/male ratio 2:1), age, the older the patient, the greater the risk, even patient cooperation is of paramount importance. Classified according to the time that has elapsed after surgery, dislocations can be early, less than 1 month, medium-term, between 1 month and 1 year, or late, 1 year after the procedure.
Dislocation after total hip replacement - Symptoms
The prosthetic femoral head is positioned outside the acetabulum or prosthetic cotyloid cavity and displaces proximally, causing considerable asymmetry of the lower limb. Pain and claudication during walking. Instability and functional disability.
Hip Dislocation - Orthotic Treatment
Some guidelines or recommendations in post-surgery can help to prevent hip dislocation to some extent, such as patients avoiding crossing their legs, not rotating the operated leg, limiting flexion of the hip, spreading the load, etc. In the event that the dislocation is present as a post-surgical complication, it will require an orthotic system for the multi-positional control of the hip joint. Anti-luxation hip orthoses, featuring a pelvic basket joined to a thigh support by means of a flexion and abduction-adduction control joint enables the hip joint to be kept in a certain position, allowing the patient to stand and walk, and undergo rehabilitation, which is essential for full repair. Anti-luxation hip orthoses are suitable as a preventive measure in cases where certain post-operative instability is evident during the rehabilitation period.