THR dislocation after 4 months!

[Guest guest]

Imagine a worst nightmare scenario. You go to bed as normal one evening -

and wake in the middle of the night to agonising pain in your hip, and

completely unable to move your leg or get out of bed.

This happened to me last Saturday night. My hip prosthesis completely

dislocated while I was sleeping. (this was a LTHR done on 4th August at

Poriya Hospital in north Israel, where I live.) I woke up at 3am to sudden

sharp pain in my hip, and with no control over my leg (which nevertheless

moved itself into an outward bent position). Luckily I have an emergency

alarm button by my bed (I am 65 and live alone) - I managed to reach and

press the button - the ambulance arrived quickly and took me on stretcher to

the local hospital ER - they did x-rays, found the hip dislocated, and

transferred me in another ambulance to the hospital where the original

surgery was done. In the afternoon I was taken into the operating room,

where a " closed reduction " was done under spinal anaesthesia (in other

words, they got the joint back into place without cutting me open). They

kept me in bed for 3 days with my leg in traction, then discharged me home

yesterday. They warned me that my hip is now very instable, and could

dislocate again at any time if I'm not careful. So I'm now back on a

walking frame, with all the old restrictions again (as for the 6 weeks

following the original surgery). They told me to return on Sunday 28th Dec

for further surgery - revision of the prosthesis cup. Meanwhile to be very

careful and do as little activity as possible.

The surgeon explained to me what had happened. First, the socket cup had

been incorrectly positioned in the acetabulum during the original surgery.

(He admits this was due to his mistake!!!) Since then, the cup had

shifted, so that instead of fitting snugly within the acetabulum, it was

partially projecting out. Then, last Saturday, the ball had completely come

out of the socket. [no wonder I was in agony!!] The closed reduction

got the ball back into the socket (and relieved my pain). Now, revision

surgery is required to reposition the cup correctly and fix it firmly.

I guess this explains my slow recovery progress - before the dislocation, I

was still limping and needed to use a cane for walking. (despite all the

PT, swimming, water exercises I had been doing - which did help a lot in

strengthening my muscles - but didn't entirely return my walking to normal.)

And I had been getting some muscle pain especially around the top of my

thigh, whenever I overdid things - walked too far or moved too vigorously in

the pool. My PT told me some time ago that she suspected the surgery

hadn't been done properly, and she had been urging me to get a second

opinion - but I decided to wait and give the swimming a chance - I had been

going to the pool 4 times a week, and did feel definite improvement; and I

had been due for another follow-up appointment with my surgeon next Sunday.

Tomorrow I am going for a second opinion to another orthopedic surgeon in

Haifa (recommended by my PT, and with the knowledge of my first surgeon).

I shall have to go by taxi, as I can't drive at present. The hospital have

given me the CD with my x-rays on it; so I'll see what he has to say. Then

I'll have to consider my options and decide whether to return and have the

revision surgery done at the same hospital and by the same surgeon; or

whether I have an option to have it done at another hospital (which will

involve travelling further and probably also a longer wait). And of

course, later, I intend to claim for compensation against the hospital for

medical negligence..... but my first priority is to get it put right.

Needless to say, i am extremely disappointed!!! Just when I thought I was

nearly recovered and getting back to normal life and activities - now,

suddenly, all that has to be put on hold, and I shall have to undergo the

whole process all over again - surgery, rehab, recovery, healing.....

The muscles that have so recently healed will have to be cut again....

(will they heal so well a second time??) Luckily, the lower part of the

prosthesis seems to be OK, it is only the cup that has to be corrected - so

my surgeon says that the surgery will be shorter [and I hope less invasive]

than the original surgery, and the rehab and recovery time hopefully

quicker. [Thankfully my muscles are now strong due to all the exercise

I've been doing!]

My own general doctor is very supportive and sympathetic - she phoned me

this morning. She says it's a very rare occurrence, and she was surprised -

this surgeon has a very good reputation, and she has had several patients

who had hip replacements done by him without any complications; mine is the

first she's heard of.

My word of advice to anyone else who may be experiencing

slower-than-expected recovery or pain after THR - get it checked! If I had

taken my PT's advice, and sought a second opinion earlier, maybe this could

have been spotted at an earlier stage, before it actually dislocated.

(though I guess revision surgery would still have been required to correct

the original mistake - nevertheless it could have been planned, and I

wouldn't have had to undergo the shock and trauma of a sudden unexpected

dislocation!)

Has anyone else undergone a similar experience?

Margaret

Galilee, Israel