A Loose Hip Responds to the Right SurgeryDislocating a hip is painful, but treatment can help. The doctor will put the patient to sleep and move the joint back in place. Sometimes the same hip dislocates more than once. There are three directions a hip can go: forward (anterior), sideways (lateral), or backwards (posterior).
Repeated dislocations can be a painful problem for the patient. Even when no pain is present, there's a worry that the joint will dislocate and the leg will give away without notice. This is the first report of a recurring hip dislocation solved by an operation called a periacetabular osteotomy.
"Osteotomy" means to cut through the bone. In this operation, the doctor cuts around the hip socket (acetabulum) and aims the socket in a new direction. The new position holds the ball at the top of the thighbone in the joint.
This case is unusual. The patient had nine past anterior dislocations of the same hip. She'd had one operation to repair the problem, but it didn't work. This 35-year old woman was unique in that she had other risk factors for recurring hip dislocation.
She had a condition called systemic lupus erythematosus. Lupus is an inflammatory disease affecting many parts of the body. In this case, the patient was taking drugs for lupus that cause loose joints. And there was a problem with the way her hip was formed, making it possible for the hip to slip out of the socket easily.
After nine hip dislocations, her doctor performed the periacectabular osteotomy. The operation worked.
The doctor in charge of this case points out that a hip that dislocates over and over needs careful review. Before doing surgery, the hip joint must be studied for any unusual changes. The right operation can help prevent multiple dislocations.
Robert T. Trousdale, MD. Recurrent Anterior Hip Instability After a Simple Hip Dislocation: A Case Report. In Clinical Orthopaedics and Related Research. March 2003. Vol. 408. Pp. 189-192.
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