MY HIP HAS DISLOCATED AFTER A TOTAL HIP REPLACEMENT

While the success rate of total hip replacement is very high and patient satisfaction is in excess of 90%, complications can occur. Some of the early complications following hip replacement include inflection, deep venous thrombosis, and dislocation. The rate of dislocation as, reported in Medicare data, can be as high as 3.8%. Most large series of joint replacements done by specialists in joint replacement have a dislocation rate in the 1% to 2% range. The causes of dislocation are multifactorial. They can include the type of implant used, the position of the implants, the activity of the patient, and the type of approach utilized. Traditionally, posterior approaches to the hip have had a somewhat higher dislocation rate, but with the advent of capsular repair and the use of larger heads, the dislocation rate as a result of the posterior approach, has decreased. The anterior approach has had a lower rate of dislocation, as the majority of dislocations following hip replacement are posterior and an anterior approach preserves the posterior soft tissue of the hip. If a hip dislocates in the early postoperative period, most often it can be reduced with sedation and/or a general anesthetic. However, once a dislocation occurs there is a 30% risk of recurrent dislocation. If a patient has multiple dislocations then it is possible that revision surgery will be necessary and the overall success rate for recurrent dislocation is approximately 60%. Therefore, it is in everyone’s interest to minimize the risk factors for dislocation.