Akwuole Frances, Pfennig Mitchell, Grayson Whisper, Brown Nicholas
Orthopaedic Surgery, Loyola University Chicago Stritch School of Medicine, Maywood, USA.
Orthopaedic Surgery, Loyola University Medical Center, Maywood, USA.
Cureus. 2024 Nov 14;16(11):e73706. doi: 10.7759/cureus.73706. eCollection 2024 Nov.
Prosthetic hip dislocations following total hip arthroplasty can significantly impact patient quality of life and functional capabilities. Early dislocations typically occur within the first three months post-surgery, while delayed dislocations arise after three months. Notably, patients may experience implant instability and dislocation for years, even decades, after the initial procedure due to a variety of underlying issues. A comprehensive evaluation including patient history, physical examination, and imaging studies is essential for diagnosing delayed dislocations. Reducing prosthetic hip dislocations can be particularly challenging, often necessitating the cooperation of multiple healthcare professionals to perform a series of reduction maneuvers. For this reason, it is surprising when an individual is able to self-reduce a dislocated prosthetic hip. Documenting this instance of self-reduction can foster dialogue among orthopedic surgeons and healthcare providers, ultimately enhancing the management strategies for similar cases in the future. In this study, the case of a 73-year-old male with a six-month history of painless, recurrent prosthetic hip dislocations with self-reduction is detailed. Self-reduction was performed via maneuvers including right lower extremity extension and external rotation. To corroborate the patient's story, multiple X-rays were obtained. These images demonstrated an initially stable right hip prosthesis, followed by evidence of a dislocated femoral implant, and concluded with a reduced hip after self-reduction. Self-reduction of a prosthetic hip dislocation by a patient is unusual, therefore presenting a unique case. The primary purpose of this case report is to describe this case of self-reduction, increase awareness of this instance, and highlight the importance of obtaining serial imaging to thoroughly identify a potential dislocation.
全髋关节置换术后的人工髋关节脱位会显著影响患者的生活质量和功能能力。早期脱位通常发生在术后的前三个月内，而延迟性脱位则出现在三个月之后。值得注意的是，由于各种潜在问题，患者在初次手术后数年甚至数十年可能会经历植入物不稳定和脱位。包括患者病史、体格检查和影像学检查在内的全面评估对于诊断延迟性脱位至关重要。减少人工髋关节脱位可能特别具有挑战性，通常需要多名医护人员合作进行一系列复位操作。因此，当一个人能够自行复位脱位的人工髋关节时，这是令人惊讶的。记录这种自行复位的情况可以促进骨科医生和医护人员之间的对话，最终增强未来类似病例的管理策略。在本研究中，详细介绍了一名73岁男性患者的病例，该患者有六个月无痛性、复发性人工髋关节脱位并自行复位的病史。自行复位是通过包括右下肢伸展和外旋在内的操作进行的。为了证实患者的情况，拍摄了多张X光片。这些图像显示右髋关节假体最初稳定，随后有股骨植入物脱位的证据，最后自行复位后髋关节恢复正常。患者自行复位人工髋关节脱位的情况并不常见，因此呈现出一个独特的病例。本病例报告的主要目的是描述这种自行复位的病例，提高对该病例的认识，并强调获取系列影像学检查以彻底识别潜在脱位的重要性。
