Postoperative Hip Dislocation

CLINICAL

The incidence of hip dislocation in total hip replacements ranges from 1% to 15% according to various publications. Different factors can cause prosthetic hip dislocation, such as poor orientation of the components, insufficient neo-capsule, conflict between the bony structures, soft tissue tension, generalised muscle weakness with gluteal insufficiency, etc. A bad choice of implant, patient age or medial fractures are usually the most likely triggering factors. Hip arthroplasty is mainly performed due to the presence of coxarthrosis or hip fractures. Two
thirds of dislocations are successfully resolved noninvasively, the rest require surgical revision. Factors such as gender (female/male ratio 2:1), age, the older the patient, the greater the risk, even patient cooperation is of paramount importance. Classified according to the time that has elapsed after surgery, dislocations can be early, less than 1 month, medium-term, between 1 month
and 1 year, or late, 1 year after the procedure.

SYMPTOMS

The prosthetic femoral head is positioned outside the acetabulum or prosthetic cotyloid cavity and displaces proximally, causing considerable asymmetry of the lower limb. Pain and claudication during walking. Instability and functional disability.

ORTHOTIC TREATMENT

Some guidelines or recommendations in post-surgery can help to prevent hip dislocation to some extent, such as patients avoiding
crossing their legs, not rotating the operated leg, limiting flexion of the hip, spreading the load, etc. In the event that the dislocation
is present as a post-surgical complication, it will require an orthotic system for the multi-positional control of the hip joint. Anti-luxation
hip orthoses, featuring a pelvic basket joined to a thigh support by means of a flexion and abduction-adduction control joint enables
the hip joint to be kept in a certain position, allowing the patient to stand and walk, and undergo rehabilitation, which is essential
for full repair. Anti-luxation hip orthoses are suitable as a preventive measure in cases where certain post-operative instability is evident
during the rehabilitation period.