For a study, the researchers sought to determine how successful emergency physicians in the emergency room (ED) were at lowering dislocation of a total hip arthroplasty (dTHA) levels while under procedural sedation (PSA). Patients with a dislocated prosthetic hip who presented to the emergency room were eligible to participate. A retrospective cohort analysis was conducted to determine the success rate. Time to reduction, ED discharge rate, and complication rate were secondary measures. A total of 305 patients were examined. 31 were omitted due to hemi-arthroplasty, and 25 were excluded since they primarily went to the operating room for reduction. A total of 249 patients were enrolled in the study. 230 (92%, 95% confidence interval [CI] 89–96%) of 249 attempted reductions in the ED were effective. After effective reduction, 71 cases (28.5%, 95% CI 22.9–34.2%) were discharged from the ED. 6 instances (2.4%, 95% confidence interval 0.2–2.6%) had PSA-related issues, and 3 cases (1.2%, 95% confidence interval 0.5–4.3%) had reduction-related difficulties. Reducing a dTHA could be done safely and successfully in the ED under PSA by emergency physicians.
Source:www.jem-journal.com/article/S0736-4679(21)00772-1/fulltext