Neglected Total Hip Dislocation

Abstract

Background: Dislocation of total hip arthroplasty (THA) needs prompt intervention and reduction either closed or open. It is unusual to left THA dislocated. Hence in this study, the outcomes of neglected prosthesis after THA were determined.

Methods: In this case series study, 15 neglected cases of total hips which had been left unreduced for long time (more than 3 months) were assessed. Cause of postponing reduction, femoral side and acetabular side defects, approach and type of revised prosthesis, Harris hip score (HHS), and other complications were studied.

Results: The results in this study demonstrated that financial issues were the cause of delayed attempt for treatment in 5 cases and the other 10 cases had delay for treatment, because they searched for a specialist to accept performing an operating on them. There were some acetabular side and femoral side defects. By Paprosky classification, in femoral side, there were 6 defects: four type 2, one type 3A, and one 3B. In acetabular side, there were 10 defects (three type 1, one type 2a, three type 2b, one type 3a, and two type 3b). In one developmental dysplasia of the hip (DDH) case, previous osteotomy site was revised (distal segment rotated and then refixed)

Conclusion: Totally, according to the obtained results, it may be concluded that outcomes were relatively good in neglected prosthesis cases after THA. However, recognition of high-risk cases and reduction of delay time may improve the outcomes.