Dislocation of total hip arthroplasty (dTHA) is a frequent emergency room consequence (ED). Several studies have been undertaken to describe the overall success rate after a reduction in the ED. However, all have had small sample sizes. For a study, researchers sought to determine the success rate of dTHA reduction by emergency doctors in the ED under procedural sedation (PSA). Patients who reported to the emergency department with a dislocated prosthetic hip were eligible to participate. They conducted a retrospective cohort analysis to determine the success rate. Secondary variables were time to reduction, ED discharge rate, and complication rate.
There were 305 patients who were studied. Of them, 31 were discarded owing to hemiarthroplasty and 25 because they went to the operating room primarily for reduction. There were 249 patients in all. About 230 (92%, 95% CI 89–96%) of 249 attempted decreases in the ED were effective. After effective reduction, 71 patients (28.5%, 95% CI 22.9–34.2%) were released from the ED. About 6 instances (2.4%, 95% CI 0.2–2.6%) had PSA-related issues, while three cases (1.2%, 95% CI 0.5–4.3%) had reduction-related difficulties. The reduction of a dTHA may be done safely and successfully in the ED under PSA by emergency doctors.
Reference:www.jem-journal.com/article/S0736-4679(21)00772-1/fulltext
