Prosthetic Hip Dislocation

Prosthetic hip dislocations are a common occurrence in the ED.  After you have gotten the hip back in place there are several ways to prevent the hip from coming out again.  An abductor pillow will work but it confines the patient to bed.  A better option to prevent further hip dislocations until the patient can get an appropriate brace made or revision surgery is to place the patient in a straight leg knee immobilizer. It is nearly impossible to dislocate your hip if your knee is fully extended.

 

So after reduction of their simple hip dislocation (i.e: no fractures or hardware malfxn) place the patient in a straight leg knee immobilizer and they can follow-up with ortho as an outpatient, but discuss with ortho.  If they have dislocated before, they meet criteria for revision and will likely need admission.  If there was no trauma, admission likely as well.

 

References

[1] http://www.wheelessonline.com/ortho/dislocation_of_tha

[2] http://www.med.nyu.edu/pmr/residency/resources/general%20MSK%20and%20Pain/rehab%20after%20hip%20and%20knee%20replacement-Brander%202006.pdf