Background: Dislocation of a hip prosthesis is a painful event which has an incidence of 4% for primary total hip arthroplasty. Relocation is traditionally performed under general anaesthesia in the operating theatre, but relocation using sedation in the emergency department (ED) has been reported, with a limited success rate of 62%. A study was undertaken to compare door to relocation times for ED sedation and theatre general anaesthesia.
Methods: The notes of all patients attending five centres in the south west of England with prosthetic hip dislocation over a 12-month period between 2005 and 2006 were retrospectively reviewed using standardised data collection forms.
Results: Successful ED reduction was significantly quicker than failed ED reduction and theatre-based general anaesthesia (2 h 21 min vs 8 h 32 min; p<0.001). No statistical difference was found between failed ED reduction and theatre general anaesthesia.
Conclusions: Reduction of dislocated hip prostheses in the ED saves nearly 6 h compared with theatre-based general anaesthesia and is therefore advocated.
Statistics from Altmetric.com
Competing interests: None declared.
Ethics approval: The local research ethics committee did not require formal review of this study.
Contributions: JG collated and analysed the raw data and co-wrote the paper. GS, NB, HS and SM collected the data from their respective emergency departments. LJ and JB advised and helped supervise the study; JB edited the paper. GL had the original idea, supervised the study, co-wrote the paper and acts as guarantor.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.