Avoiding the Pain of Hip Dislocation


NEW YORK, N.Y. (Ivanhoe Newswire) — Two and a half million Americans are now living with an artificial hip. Most recover well after surgery, but some patients run the risk of having the new joint dislocate.  There are steps to take to prevent the excruciating pain from a “popped” hip.

Seventy-two year old Joanne Welsch is a nurse and was on her feet all the time, until her hip started to hurt.

She told Ivanhoe, “It was never really pain. It was always burning.”

Joanne needed a new hip. Doctors replaced her old joint with a titanium stem-and ball and socket. She was careful to follow what doctors call hip precautions during recovery.

Nakul Karkare, MD, NY orthopedic surgeon said, “You should not be crossing your legs. You should not be bending your hip beyond 90 degrees for about six to eight weeks after the procedure.”

Joanne followed doctor’s orders, but weeks after surgery she turned her torso slightly and had sudden, searing pain in her hip.

Joanne said, “And I felt it pop so I sat down on the ground, which was the only place I could get myself to, and I shimmied across the entire backyard on my behind.”

Joanne’s hip dislocated, not just once, but three times over a period of months.

Orthopedic surgeon Nakul Karkare met Joanne in a New York hospital after the third dislocation and thought she would be a good candidate for a newer joint.

Karkare told Ivanhoe, “It’s a constrained liner, which means that the head is somewhat fixed into the socket.”

With the newer joint, patients have a better range of motion, which also helps to prevent dislocation.

“A lot of this is mental, you are just waiting for this to happen again,” Joanne said.

With her new replacement, Joanne is confident that her days of dislocation are behind her.

In addition to the constrained liner, Doctor Karkare says patients may also have the option of another newer replacement called an “MDM head.” The “head” of the joint is much larger than normal, making it difficult to come out of the socket.

Contributors to this news report include: Cyndy McGrath, Field Producer; Brogan Morris, Assistant Producer; Kirk Manson, Videographer; and Tony Dastoli, Editor.

REPORT #2336

(Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00377)BACKGROUND: Over 300,000 hip replacement surgeries are performed annually in the United States. When the anatomy that allows the joint to move easily experiences complications due to osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, avascular necrosis, or childhood hip disease, hip replacement surgery may be recommended. The procedure was first performed in 1960, and since then improvements in surgical techniques and technology have greatly increased the effectiveness of total hip replacements. The operation involves removing damaged bone and cartilage from the hip and replacing it with prosthetics. A metal stem replaces the damaged femoral head and is placed into the hollow center of the femur. A metal or ceramic ball is placed on the upper end of the stem and is connected to a metal prosthetic socket. This replaces the damaged cartilage surface of the bone socket and is usually kept in place using either cement or screws. A plastic, ceramic or metal spacer is inserted between the new ball and socket, and allows for a smooth gliding surface.

RECOVERY: The day after surgery, patients will begin standing and walking with the help of a physical therapist. Exercises are taught to help restore strength and motion in the hip required for daily activities. Exercises can be performed with bed support or standing while holding on to a firm surface for balance. These include:

  • Ankle rotations
  • Knee bends
  • Knee raises
  • Leg Abduction Exercise: sliding your leg out to the side as far as you can and then back
  • Straight leg raises

The rate of complications following total hip replacement surgery is generally low; serious complications occur in less than two percent of patients. Infections, blood clots, leg-length inequality, and dislocation are all possible complications. In some cases, revision surgery is required. Newer, stronger replacements such as constrained liners and dual mobility cups, such as an MDM, may reduce the likelihood of certain complications.

(Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00377, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095010/)

MORE FROM DOCTOR KARKARE: “The prior surgery (for this patient) that led to 3 dislocations was done by another surgeon. I am among the very few surgeons in USA capable of treating dislocations. She already had two surgeries to stop the dislocation by some other surgeon that failed. I did her surgery just once two years ago and her hip has not dislocated since.”

* For More Information, Contact:

Gary Grasso



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