scholarly journals Atraumatic Posterior Hip Dislocation following Short Femoral Nail for Intertrochanteric Fracture Treated by Dual Mobility System in Total Hip Arthroplasty: A Case Report

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Yasuhisa Yoshida ◽  
Akira Yoshida ◽  
Yuto Takashima ◽  
Hideto Fujii
Keyword(s):  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Intertrochanteric Fracture ◽  
Hip Dislocation ◽  
Dual Mobility ◽  
Intertrochanteric Hip Fracture ◽  
Mobility System ◽  
Posterior Hip Dislocation

Introduction: Atraumatic hip dislocation after short femoral nail (SFN) fixation for an intertrochanteric fracture is extremely rare. Case Report: An 84-year-old woman presented with an atraumatic posterior hip dislocation that occurred 8 years after SFN fixation for an intertrochanteric hip fracture. She experienced an acute-onset left hip pain when standing up from a sitting position while bathing at a day care facility. We performed total hip arthroplasty (THA) with a dual mobility system. During the post-operative THA evaluation, the combined anteversion angle was within the optimum range of 57. However, the dislocation recurred after the THA. During the revision THA, a dual mobility system was used to moderately extend the stem neck. Measures were adopted to strain the posterior soft tissues of the hip joint. We speculated that the posterior hip joint capsule ruptured because the support of the posterior hip joint was weak after the intertrochanteric hip fracture. At the final follow-up visit at 6 months after the operation, the hip joint pain had disappeared, and her activities of daily living recovered to almost the same level as her preinjury activities. Conclusions: We should consider the lack of support of posterior soft tissues as a cause of this atraumatic posterior hip dislocation following intertrochanteric fracture fixation. Keywords: Atraumatic posterior hip dislocation, post-operative state of intertrochanteric hip fracture, short femoral nail, total hip arthroplasty, dual mobility system.

scholarly journals Nonunion of the bone fragments during total hip replacement with T. Paavilainen osteotomy — causes of failure

2020 ◽  
Vol 8 (2) ◽  
pp. 119-128
Author(s):  
Alexandr I. Avdeev ◽  
Igor A. Voronkevich ◽  
Dmitrii G. Parfeev ◽  
Anton N. Kovalenko ◽  
David G. Pliev ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Greater Trochanter ◽  
Total Hip ◽  
Shortening Osteotomy ◽  
History Of ◽  
Bone Fragments

Background. Conservative treatment options for hip dysplasia and hip dislocation in early childhood allow for good results in cases of a timely diagnosis. The preferred treatment option for patients with hip dislocation in adulthood is total hip joint replacement. The shortening osteotomy, proposed by T. Paavilainen, allows the surgeon to restore the difference in the lengths of the lower extremities during arthroplasty of the hip joint. However, according to the results of the Paavilainen technique, as presented by Russian orthopedic surgeons, the problem of nonunion of the greater trochanter fragment with the diaphysis of the femur remains unresolved, as evidenced by a massive group of clinical cases. Aim. The aim of this study was to identify factors affecting the consolidation of bone fragments after osteotomy of the greater trochanter, according to T. Paavilainen, during total hip arthroplasty and evaluate their significance after fixation with cerclage screws in comparison with a special trochanteric fork-plate. Materials and methods. The present study includes 208 cases that were treated at the Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden from 2003 to 2019 using various fixation techniques of the greater trochanter fragment. Patients were divided into two groups depending on their type of fixation. The quality of consolidation of a greater trochanter fragment with the femur was assessed during a follow-up period of six months or longer. The fragment of the greater trochanter was divided into the part that was not in contact with the diaphysis, or A, and the part that was in contact with the diaphysis, or B. We assessed the effect of the absolute value of the contact between fragments, the B/A ratio, the distance between the points of insertion of the screws into the diaphyseal part of the femur, the quality of the bone by the modified Barnet-Nordin index, and the history of previous surgical interventions on this joint on the consolidation. Results. When the part of the greater trochanter was in contact with the diaphysis of the femur (B) was less than 3.5 cm, the risk ratio of nonunion of the greater trochanter fragment with the diaphysis of the femur increased. Also, a significant factor is the index of the contact of the greater trochanter fragment (B/A less than 1) with the diaphysis of the femur using the T. Paavilainen technique. In addition, the presence of surgical intervention in the hip joint history significantly increases the relative risk (RR) of nonunion of the greater trochanter fragment with the diaphysis of the femur with this method of shortening osteotomy of the femur. Conclusion. In the absence of timely diagnosis and conservative treatment of children with hip dislocation, reconstructive-plastic techniques on the hip joint do not allow the achievement of proper results and increase the complexity of total hip arthroplasty. According to the results of this study, the absolute value of the contact between fragments (B), the index of the greater trochanter contact with the diaphysis of the femur, and the history of previous surgical intervention on this joint are objective tools for the prognostic assessment of the probability of fragment unions during total hip arthroplasty with the T. Paavilainen technique.

Intraprosthetic Dislocation of Modular Dual-Mobility Total Hip Arthroplasty Components During Closed Reduction: A Report of Two Cases

2017 ◽  
Vol 01 (04) ◽  
pp. 205-210
Author(s):  
Ovninder Johal ◽  
Blake Eyberg ◽  
Russell Meldrum ◽  
J. Walker
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Dual Mobility ◽  
Total Hip ◽  
Unique Mode ◽  
Mode Of Failure ◽  
Hip Disease ◽  
Intraprosthetic Dislocation

AbstractDual-mobility bearing total hip arthroplasty offers several advantages over traditional prosthesis designs in the treatment of degenerative hip disease. Over decades of use, they have shown proven benefits in both durability and stability. However, despite their practical and theoretical advantages, they present a unique mode of failure not seen with other implants. In this report, the authors present two patients who sustained intraprosthetic dislocation of their dual-mobility total hip arthroplasty components during closed reduction of a hip dislocation.

scholarly journals “Acute Primary Total Hip Arthroplasty for Combined Posterior Acetabulum Fracture with Ipsilateral Associated Posteriorly Dislocated Femoral Head with Femoral Neck Fracture. Using of Femoral Head as an Autograft Would be an Advantage”

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Babaji Thorat ◽  
Avtar Singh ◽  
Mohammad Arshad ◽  
Sharad Salokhe ◽  
Ravi Mavani
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
High Energy ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
Neck Fracture ◽  
Posterior Hip Dislocation

Introduction: Traumatic posterior hip dislocation with comminuted fracture of the ipsilateral acetabulum and femoral neck is a rare fracture pattern. These injuries are associated with high energy trauma and pose challenges during management. Controversy exists between hip preservation and replacement surgeries in middle-age patients. Open reduction and internal fixation (ORIF) have a high risk of non-union, avascular necrosis, and post-traumatic osteoarthritis of hip requiring total hip arthroplasty hip replacement (THA) as a secondary procedure later. Case Report: A 56-year-old male presented with posterior hip dislocation and comminuted fracture of ipsilateral wall and column of the acetabulum, and femoral neck following a high energy trauma. He was managed by acetabular reconstruction using femoral head structural autograft combined with acute primary uncemented THA. At 2-year follow-up, the patient had good functional outcome with a satisfactory range of motion without any difficulty in weight-bearing and doing his daily activities. Conclusion: Although uncommon, acetabular reconstruction using femoral head structural autograft and acute primary uncemented THA is a viable alternative treatment option compared to ORIF in middle-age patients with fracture of ipsilateral neck and acetabulum. This facilitates post-operative rehabilitation and avoids further operations for possible developing AVN or secondary arthritis. Keywords: Hip dislocation, acetabulum fracture, femur neck fracture, acute total hip arthroplasty, acetabular reconstruction, femoral head structural autograft.

Neglected Posterior Hip Dislocation in Adults presenting after One Year Managed Successfully with Single Stage Total Hip Arthroplasty: A Case Series

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Mantu Jain ◽  
Shakti Swaroop ◽  
Doki Sunil Kumar
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Case Series ◽  
Hip Dislocation ◽  
Single Stage ◽  
Total Hip ◽  
One Year ◽  
Posterior Hip Dislocation

Neglected Posterior Hip Dislocation in Adults presenting after One Year Managed Successfully with Single Stage Total Hip Arthroplasty: A Case Series

scholarly journals RISK FACTORS AND POTENTIALITIES OF DISLOCATION PREVENTION AFTER TOTAL HIP ARTHROPLASTY

2017 ◽  
pp. 63-72
Author(s):  
D. V. Stafeev ◽  
N. N. Efimov ◽  
E. P. Sorokin ◽  
D. V. Chugaev ◽  
A. I. Gudz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Literature Review ◽  
Femoral Component ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Dual Mobility ◽  
Total Hip ◽  
Mobility System ◽  
Independent Risk Factors

The literature review is dedicated to the problem of femoral component dislocation after primary and revision total hip arthroplasty. Modern data on surgeon-dependent and -independent risk factors for this complication development are analyzed. Potentialities for dislocation prevention using constrained liners and dual mobility system are considered. 

Neglected acetabular fracture with hip dislocation in a 34-year-old subject treated with total hip arthroplasty: our experience

2021 ◽  
Vol 14 (11) ◽  
pp. e245793
Author(s):  
Pierluigi Pironti ◽  
Ricardo A Ciliberto P ◽  
Paolo Sirtori ◽  
Laura Mangiavini
Keyword(s):  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Hip Dislocation ◽  
Skeletal Traction ◽  
Total Hip ◽  
Fracture Dislocations ◽  
Feasible Option

Neglected hip fracture-dislocations are rare but still possible clinical situations, especially in developing countries. Some authors described skeletal traction and open reduction with internal fixation as a treatment for the abovementioned conditions. Despite the poor literature about this topic, total hip arthroplasty (THA) may be a feasible option in the treatment of neglected hip fracture-dislocations. We present a case of a 34-year-old Moroccan man reporting a 1-year neglected acetabular fracture with hip dislocation successfully treated with THA. The patient showed a significant improvement of pain, range of motion and his quality of life at 45 days. Our experience shows how a neglected acetabular fracture with hip dislocation can be successfully treated with THA. Considering the complexity of these cases, an accurate preoperative planning is mandatory and the prosthetic components’ choice must be customised to the patient.

scholarly journals Outcome of dual mobility total hip arthroplasty in patients who are at high risk for dislocation

2021 ◽  
Author(s):  
Basavaraj S. Kyavater ◽  
Rafeeq M. D. ◽  
Sathish Kumar ◽  
Hemanth P. Hallinalli
Keyword(s):  
High Risk ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Dislocation ◽  
Dual Mobility ◽  
Total Hip ◽  
A Prospective Study

<p><strong>Background: </strong>Dislocation after total hip arthroplasty (THA) remains a major concern, because it is reported to range from 1% to 5%. The concept of dual mobility articulation was developed in 1970 by Bousquet to decrease dislocation risk. Several studies have looked at the outcome of dual mobility articulation in primary THA and in revision THA.<strong></strong></p><p><strong>Methods: </strong>This is a prospective study of 33 patients undergoing dual mobility THA during 24 months period from October 2017 to September 2019. Patients undergoing total hip replacement (THR) to have dual mobility cup (DMC) were those at high risk of dislocation. Patients were followed up for a mean period of 18 months.<strong></strong></p><p><strong>Results: </strong>33 patients (mean age 67 years) underwent DMC THA. 27 patients underwent primary hip replacement. The follow-up of our cases has ranged from 13 months to 3 years with a mean follow-up of 18 months. none of the patients had hip dislocation.</p><p><strong>Conclusions</strong>: The DMC is an effective solution for the management of high-risk cases undergoing total hip replacement to reduce the incidence of postoperative instability.</p>

Total hip arthroplasty following failed intertrochanteric hip fracture fixation treated with a cephalomedullary nail

2019 ◽  
Vol 101-B (6_Supple_B) ◽  
pp. 91-96 ◽  
Author(s):  
A. Smith ◽  
K. Denehy ◽  
K. L. Ong ◽  
E. Lau ◽  
D. Hagan ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fracture Fixation ◽  
Salvage Procedure ◽  
Total Hip ◽  
Intertrochanteric Hip Fracture ◽  
Lower Socioeconomic ◽  
Increased Risk

Aims Cephalomedullary nails (CMNs) are commonly used for the treatment of intertrochanteric hip fractures. Total hip arthroplasty (THA) may be used as a salvage procedure when fixation fails in these patients. The aim of this study was to analyze the complications of THA following failed intertrochanteric hip fracture fixation using a CMN. Patients and Methods Patients who underwent THA were identified from the 5% subset of Medicare Parts A/B between 2002 and 2015. A subgroup involving those with an intertrochanteric fracture that was treated using a CMN during the previous five years was identified and compared with the remaining patients who underwent THA. The length of stay (LOS) was compared using both univariate and multivariate analysis. The incidence of infection, dislocation, revision, and re-admission was compared between the two groups, using multivariate analysis adjusted for demographic, hospital, and clinical factors. Results The Medicare data yielded 56 522 patients who underwent primary THA, of whom 369 had previously been treated with a CMN. The percentage of THAs that were undertaken between 2002 and 2005 in patients who had previously been treated with a CMN (0.346%) more than doubled between 2012 and 2015 (0.781%). The CMN group tended to be older and female, and to have a higher Charlson Comorbidity Index and lower socioeconomic status. The mean LOS was 1.5 days longer (5.3 vs 3.8) in the CMN group (p < 0.0001). The incidence of complications was significantly higher in the CMN group compared with the non-CMN group: infection (6.2% vs 2.6%), dislocation (8.1% vs 4.5%), revision (8.4% vs 4.3%), revision for infection (1.1% vs 0.37%), and revision for dislocation (2.2% vs 0.6%). Conclusion The incidence of conversion to THA following failed intertrochanteric hip fracture fixation using a CMN continues to increase. This occurs in elderly patients with increased comorbidities. There is a significantly increased risk of infection, dislocation, and LOS in these patients. Patients with failed intertrochanteric hip fracture fixation using a CMN who require THA should be made aware of the increased risk of complications, and steps need to be taken to reduce this risk. Cite this article: Bone Joint J 2019;101-B(6 Supple B):91–96.

Sign in / Sign up

Export Citation Format

Share Document