OPEN REDUCTION OF A CHRONIC PROXIMAL DISLOCATION AFTER TOTAL HIP ARTHROPLASTY. A CASE REPORT

Abstract

Total hip arthroplasty (THA) is a commonly performed surgical procedure for various arthritic conditions that affect the hip joint, and it has proven to be highly effective for the relief of pain and improvement in the quality of life. Despite many recent advances in THA, dislocation continues to be a frequent complication, and the incidence of dislocation ranges from 1% to 5% in primary THAs. The literature abounds with options for the treatment of recurrent dislocation after THA. However, to the best of our knowledge, successful treatment with open reduction of a chronic proximal dislocation after THA has not been reported previously in the literature.

We report an unusual case of a chronic prosthetic dislocation that was caused by the buttonholing of a prosthetic femoral head by anterior soft tissue, which impeded reduction. A surprisingly good functional result was achieved by an open reduction and revision operation on a 56-year-old man, who had a chronic dislocation of a total hip prosthesis. 5 years after the surgery, the patient has no clinical or radiographic evidence of recurrence of dislocation of THA. We believe that a chronic irreducible dislocation may hamper operations by adhesion and scar tissues. Especially soft tissue buttonholing makes it impossible to perform a closed reduction. We restored a much higher level of function by a single operation in a short time, and made the patient to be able to ambulate with fast recovery from the surgery. Equal limb lengths were restored and no neurologic compromise occurred.