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Dislocating a Hip after Total Hip Replacement is Traumatic for Patients and can be Avoided

Osteoarthritis of the hip can lead to the need for a total hip replacement, in which surgeons replace the worn, painful and often low functioning joint with an artificial prosthesis. For many, total hip replacement results in less pain, better movement and improved quality of life. This, however, is not the case for the approximately one in 50 patients who undergo total hip replacement for the first time and experience a dislocation.

Researchers reported January 5, 2015 in the German Medical Association’s scientific journal Deutsches Ärzteblatt International that dislocation can be a traumatic experience for hip joint replacement patients and it should (and can) be avoided.

They reviewed scientific articles on the topic to better determine when dislocations are likely to occur and how providers can help patients avoid the complication. The researchers found that as many as one in four of the patients who have dislocations need to have revision surgery and an implant exchange. Risks for the need for a second surgery include advanced age, as well as having neurologic diseases, such as Parkinson’s disease or muscular dystrophy. Sometimes, patients move in ways they shouldn’t after the surgery, causing a dislocation. Such movements include bending too far forward or internal rotation of the flexed hip joint.

Other reasons for increased dislocation risk include surgical mistakes and inexperience. Incorrect positioning of the implant, inadequate soft-tissue tension and inadequate experience of the surgeon can increase dislocation risk.

Prevention includes a preoperative risk assessment, proper surgical technique with optimized alignment of the implant’s components, soft-tissue balancing and adequate surgical experience. It also includes treatment of any instability after total hip replacement, which should be based on a diagnostic and therapeutic algorithm. This algorithm should determine if revision surgery is needed or if conservative approaches with physical therapy and more would best help the patient.

Physical therapists are trained in the rehabilitation of total joint replacement patients. Physical therapists often work with these patients before the surgery to strengthen the area and, potentially, improve surgical results. They also work with patients post-surgery, to restore movement, flexibility, strength and more. For more about how a physical therapist can help total joint replacement patients prepare for and recover from surgery, contact A Physical Therapist, Inc.

A Physical Therapist, Inc., is a one-on-one physical therapy clinic in Delray Beach, Fla., and Harrisburg, Penn. For patients in Palm Beach County, A Physical Therapist, Inc., is easily accessible from Boca Raton or Boynton Beach. For patients in Dauphin County, A Physical Therapist, Inc., is easily accessible from Hershey and Marysville.

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