Abstract
Background
Dislocation of total hip arthroplasty (dTHA) is a commonly encountered complication
in the emergency department (ED). Several studies have been conducted that describe
the overall success rate after reduction in the ED, however, all were small in sample
size.
Objectives
The aim of the study was to assess the success rate of reduction of dTHA by emergency
physicians in the ED under procedural sedation (PSA).
Methods
Patients who presented to the ED with a dislocated prosthetic hip were eligible for
inclusion. We performed a retrospective cohort study assessing success rate. Secondary
parameters included time to reduction, discharge rate from the ED, and complication
rate.
Results
There were 305 patients analyzed. Of these, 31 were excluded due to hemi-arthroplasty
and 25 because they went primarily for reduction in the operating room. In total,
249 patients were included. Of 249 attempted reductions in the ED, 230 (92%, 95% confidence
interval [CI] 89–96%) were successful. Seventy-one cases (28.5%, 95% CI 22.9–34.2%)
were discharged from the ED after successful reduction. Six cases (2.4%, 95% CI 0.2–2.6%)
experienced complications related to PSA and three cases (1.2%, 95% CI 0.5–4.3%) experienced
complications related to reduction.
Conclusion
Reduction of a dTHA can be performed safely in the ED under PSA by emergency physicians
with a high rate of success.
Keywords
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Article info
Publication history
Published online: January 19, 2022
Accepted:
October 17,
2021
Received in revised form:
October 13,
2021
Received:
June 16,
2021
Footnotes
Ethics approval was obtained from the local ethics committee for the conduction of this study (2016-0775).
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
