dc.contributor | Vall d'Hebron Barcelona Hospital Campus |
dc.contributor.author | Pujol Alarcón, Oriol |
dc.contributor.author | Mimendia Sancho, Iñaki |
dc.contributor.author | Martin-Dominguez, Lidia |
dc.contributor.author | Amat Mateu, Carles |
dc.contributor.author | Barro Ojeda, Victor |
dc.date.accessioned | 2022-03-31T10:49:29Z |
dc.date.available | 2022-03-31T10:49:29Z |
dc.date.issued | 2021-03 |
dc.identifier.citation | Pujol O, Mimendia I, Martin-Dominguez L, Amat C, Barro V. Simultaneous bilateral dual mobility total hip arthroplasty dislocation in a patient with hepatic encephalopathy: A case report. Int J Surg Case Rep. 2021 Mar;80:105705. |
dc.identifier.issn | 2210-2612 |
dc.identifier.uri | https://hdl.handle.net/11351/7288 |
dc.description | Dislocation; Dual mobility; Hepatic encephalopathy |
dc.description.abstract | Introduction and importance
Dislocation is a severe complication after total hip arthroplasty (THA). It is one of the most common reasons for failure and revision surgery. This is the first case of a documented simultaneous bilateral dual mobility (DM) THA dislocation.
Case presentation
A forty-nine-year-old man presented with bilateral hip pain, immobility and deformity. X-ray images demonstrated simultaneous bilateral posterior THA dislocation. Previously, the patient had presented atraumatic dislocations recurrently. When he was thoroughly re-interrogated, he complained of uncontrolled and generalized muscle contractions, which were compatible with myoclonus due to hepatic encephalopathy (HE). Multidisciplinary treatment was performed satisfactorily to control myoclonus symptomatology and to prevent dislocation.
Clinical discussion
Patient’s most important risk factor was a neuromuscular disorder, which we initially gave little notice and undervalued. HE is a serious but reversible syndrome, observed in patients with liver dysfunction. It leads to a wide spectrum of neuropsychiatric abnormalities. Management is based on prevention of episodes, avoiding the underlying triggers.
Due to the high risk for dislocation of our patient, we decided to use DM cups bilaterally. This system has demonstrated lower rates of dislocation.
Conclusion
This case report reminds us that a careful evaluation through meticulous history and physical examination are mandatory when faced with recurrent instability. Furthermore, prevention of dislocation is vastly preferable to treating this challenging complication. High-risk patients should be identified, and appropriate surgical approach, technique and implants have to be collectively used to reach a strategy that mitigates and ideally prevents dislocation. |
dc.language.iso | eng |
dc.publisher | Elsevier |
dc.relation.ispartofseries | International Journal of Surgery Case Reports;80 |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.source | Scientia |
dc.subject | Encefalopatia hepàtica |
dc.subject | Artroplàstia total de maluc - Complicacions |
dc.subject | Articulació coxofemoral - Luxació |
dc.subject.mesh | Arthroplasty, Replacement, Hip |
dc.subject.mesh | /adverse effects |
dc.subject.mesh | Hip Dislocation |
dc.subject.mesh | Hepatic Encephalopathy |
dc.title | Simultaneous bilateral dual mobility total hip arthroplasty dislocation in a patient with hepatic encephalopathy: A case report |
dc.type | info:eu-repo/semantics/article |
dc.identifier.doi | 10.1016/j.ijscr.2021.105705 |
dc.subject.decs | artroplastia de sustitución de cadera |
dc.subject.decs | /efectos adversos |
dc.subject.decs | luxación de la cadera |
dc.subject.decs | encefalopatía hepática |
dc.relation.publishversion | https://doi.org/10.1016/j.ijscr.2021.105705 |
dc.type.version | info:eu-repo/semantics/publishedVersion |
dc.audience | Professionals |
dc.contributor.organismes | Institut Català de la Salut |
dc.contributor.authoraffiliation | [Pujol O] Servei de Cirurgia Ortopèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Mimendia I, Barro V] Servei de Cirurgia Ortopèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Cirurgia de Maluc, Servei de Cirurgia Ortopèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Martin-Dominguez L] Orthopedic Surgery Department, Dexeus University Hospital, Barcelona, Spain. [Amat C] Servei de Cirurgia Ortopèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Cirurgia Sèptica i Reconstructiva, Servei de Cirurgia Ortopèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain |
dc.identifier.pmid | 33662911 |
dc.identifier.wos | 000629665100109 |
dc.rights.accessrights | info:eu-repo/semantics/openAccess |