Complication of hip replacement surgery
Hip arthroplasty, either total or hemiarthroplasty are major surgeries that carries a risk of post-operative complications.
Hip dislocation
Post-operative hip dislocation is one of the major complications following hip arthroplasty surgery. Hip dislocation could be early-onset, or late-onset dislocation with different etiologies. There are multiple factors that can predispose to post-operative hip joint dislocation. From these factors:
- Previous hip surgery
- The design of the prosthetic is not suitable or was badly positioned
- Some approaches have a higher risk of developing hip dislocation more than others
Late-onset dislocation usually occurs after five years from the hip arthroplasty, old age is one of the predisposing factors for late onset dislocation. A study by Von Knoch et al. to study late-onset hip dislocation after hip arthroplasty. They founded that 616 hip dislocation cases were reported from 25,465 cases of hip arthroplasty surgery. From these cases 0.6% were late-onset hip dislocation cases. The researchers founded some factors that can be linked to late-onset dislocations such as:
- Recurrent subluxation
- Hip trauma
- Acetabular malposition
Late- onset dislocation could be prevented by regular follow up for assessment and evaluation of the patient’s condition, and if there are any symptoms of impending dislocation.
Early-onset dislocation is the most common early complication following hip arthroplasty. It usually occurs within three months of the surgery. it is a leading cause for early revisit of total hip replacement. The etiology of early-onset dislocation is usually multifactorial. From these factors:
- Soft tissue instability
- Malposition of joint component
- Patient position was incorrect
Early-onset dislocation usually does not necessitate any surgical intervention to reposition it. There are multiple risk factors that are linked to early-onset dislocation such as:
- Old age is a major risk factor
- Females are prone to hip dislocation more than males
- A few conditions are linked to increase risk of early onset dislocation as muscular dystrophy, Parkinson’s disease, and cerebral palsy
