Door to relocation time for dislocated hip prosthesis: multicentre comparison of emergency department procedural sedation versus theatre-based general anaesthesia

Emerg Med J. 2009 Jan;26(1):39-40. doi: 10.1136/emj.2008.057737.

Abstract

Background: Dislocation of a hip prosthesis is a painful event which has an incidence of 4% for primary total hip arthroplasty. Relocation is traditionally performed under general anaesthesia in the operating theatre, but relocation using sedation in the emergency department (ED) has been reported, with a limited success rate of 62%. A study was undertaken to compare door to relocation times for ED sedation and theatre general anaesthesia.

Methods: The notes of all patients attending five centres in the south west of England with prosthetic hip dislocation over a 12-month period between 2005 and 2006 were retrospectively reviewed using standardised data collection forms.

Results: Successful ED reduction was significantly quicker than failed ED reduction and theatre-based general anaesthesia (2 h 21 min vs 8 h 32 min; p<0.001). No statistical difference was found between failed ED reduction and theatre general anaesthesia.

Conclusions: Reduction of dislocated hip prostheses in the ED saves nearly 6 h compared with theatre-based general anaesthesia and is therefore advocated.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Arthroplasty, Replacement, Hip / methods*
  • Conscious Sedation / methods*
  • Emergency Service, Hospital / organization & administration*
  • England
  • Hip Dislocation / surgery*
  • Hip Prosthesis / statistics & numerical data*
  • Humans
  • Prosthesis Failure
  • Prosthesis Implantation / methods
  • Time Factors
  • Treatment Outcome