title: Reduction of dislocated hip prosthesis in the emergency department using conscious sedation: a prospective study.
abstract: This prospective observational study aimed to determine the rate of success of reduction of dislocated hip prostheses using conscious sedation. In 101 consecutive patients presenting to the emergency department between August 2000 and February 2003 with a dislocated hip prosthesis, reduction was attempted using conscious sedation. The outcome measures of the study were (a) rate of success of the attempted reductions (b) rate of complication of the sedation or the procedure, and (c) rate of success in the three subgroups (based on degree of dislocation). The overall success rate was 62% (95% CI 53% to 71%). There were six complications: five related to sedation and one was a mild foot drop. The mean time to attempted reduction using conscious sedation was 1.83 hours and for an equivalent group who were excluded and subsequently required general anaesthesia the mean time was 10.9 hours. Reduction of isolated unilateral prosthetic hip dislocation using conscious sedation in the emergency department is safe and has a reasonable success rate. Prosthetic hip reduction can be attempted more quickly using conscious sedation than when awaiting general anaesthesia.
authors.affiliation: Emergency Department, Salisbury District Hospital, Salisbury, UK. sarah.frymann@ntlworld.com
authors.forename: S J
authors.initials: SJ
authors.lastname: Frymann
authors.forename: G L A
authors.initials: GL
authors.lastname: Cumberbatch
authors.forename: A S L
authors.initials: AS
authors.lastname: Stearman
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods*; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D006617:Hip Dislocation / Q000628:therapy*; D006801:Humans; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D011475:Prosthesis Failure; D016896:Treatment Outcome