Preventing Hip Replacement Dislocation

There are some ways to prevent dislocation of a hip replacement, which is the most common complication of hip replacement surgery.

While the ball and socket of the hip replacement are very tightly fit together, they are not actually connected—and if enough force is applied, they can become separated. A dislocation occurs when the femoral head (the ball of the ball and socket hip joint) is separated from the socket.

The risk of complications of hip replacement surgery, including dislocation, has come down over the past decade with preventative strategies. Nevertheless, when it occurs, hip dislocation may require a revision hip replacement.

X-ray illustration of hip replacement / Getty Images

Hip Replacement Dislocation

Hip replacement dislocations occur when the ball of the ball-and-socket joint replacement comes out of the socket. While your surgeon may be able to reposition it without a surgical incision, the chance of additional dislocations or damage to the implants is high. Therefore, revision hip replacement surgery is often considered.

Establishing why the hip joint dislocated is an important factor in determining the appropriate treatment. Possible reasons for a hip replacement dislocation include the type of implant used, the positioning of the implant in the body, traumatic injury, or underlying medical conditions (for example, Parkinson's disease).

Once the cause of the dislocation is identified, your surgeon will discuss your treatment options with you. Options may include a second surgical procedure to redo the hip replacement, possibly with a different type of implant.

Preventing Hip Replacement Dislocations

Recent studies have investigated why some people may be more likely to experience hip replacement dislocation. Not all factors can be controlled; for example, movement disorders like Parkinson's disease can be managed, but not cured. Another factor that cannot be controlled is age; patients over the age of 85 had a higher chance of hip replacement dislocation.

However, there are factors that can reduce the risk of hip replacement dislocation:

  • Implant size: Femoral head size options have increased dramatically in the past decade. Femoral head size can be adjusted to help prevent dislocation of the hip replacement. Larger sized femoral heads are less likely to dislocate from the socket.
  • Implant material: The implants used for hip replacements can be made of combinations of metal, plastic, and ceramic. Sometimes special implants, such as metal-on-metal hip replacements, allow your surgeon to use a larger size femoral head, and thus lower dislocation risk.
  • Surgeon experience: Surgeons performing more than 50 hip replacements each year have a lower chance of having a patient have a hip replacement dislocation.

More and more hip replacements are being performed through an anterior surgical approach, and some surgeons feel the chance of dislocation is lower with this approach. There is conflicting data about how much of a role the surgical approach could play in the risk of dislocation, however.

Bottom Line: What Should I Do?

Hip replacement surgery
is an effective treatment for hip pain caused by arthritis. If you are planning to have this surgery, you should be aware of the potential risk of dislocation of the hip replacement.

If you are particularly concerned about dislocation, you can talk to your surgeon about how you can try to lower your risk of having a dislocation complication.

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Article Sources
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