Definition
A total hip replacement, also called TEP, is a common procedure nowadays, but not always without complications. Hip dislocation, which results in a dislocated joint, is a relatively common complication after total hip replacement. If all documented complications after the operation are added together, the frequency of hip luxation after TEP is given as approx.
20%. Luxation is described as a displacement of the normally interconnected (in this case artificial) joint surfaces, whereby, according to the definition, complete articulation contact (i.e. the parts of the femoral head and acetabulum that move against each other) of the two artificial joints has been lost in a hip luxation following a total endoprosthesis. The part of the prosthesis anchored in the femoral bone was thus pressed out of the artificial acetabulum.
The joint is thus “dislocated” and no longer functional. Hip luxation after a TEP occurs in about 2% of patients in the first year after surgery. A distinction is made between a one-time and a recurrent dislocation after hip prosthesis surgery.
It is important to correct the problem quickly, otherwise the complete surgical result is endangered and the patient’s quality of life can be severely restricted by a hip luxation. (X-ray image stained)
- Cup of the hip prosthesis
- Prosthesis socket
- Prosthesis head This hip prosthesis is a so-called cement-free hip prosthesis, which is initially jammed in the bone and then grows into the bone as it progresses. You can read more about this hip prosthesis below in this topic.
Symptoms
A hip luxation after a total endoprosthesis can cause a number of different symptoms. It is a sudden and traumatic event, so a shooting, stabbing pain is typical for hip luxation after a TEP. The leg is shortened and movement is severely restricted because there is no longer any bony contact with the leg.
Targeted movements are no longer possible in hip luxation after TEP. A false rotation, i.e. incorrect rotation of the leg, can also be detected. Further symptoms are possible if structures in the surrounding area have been depressed or injured by the malposition of the bones and parts of the implant.
For example, the sciatic nerve can be affected when the hip prosthesis is dislocated, which can cause symptoms such as tingling, numbness and pain in the leg and impair motor function. Vascular injuries may occur, which would cause symptoms such as paleness, pulselessness in the leg and pain. In very severe trauma, dislocation also causes bone fragments to break out of the existing bone, which cause a soft crackling and crunching sound when the patient moves passively.
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