Anesthesia for Closed Reduction of Hip Dislocation

CLOSED REDUCTION OF HIP DISLOCATION

There is a 3% incidence of hip dislocation following primary hip arthroplasty and a 20% incidence fol-lowing total hip revision arthroplasty. Because less force is required to dislocate a prosthetic hip, patients with hip implants require special precautions dur-ing positioning for subsequent surgical procedures. Extremes of hip flexion, internal rotation, and adduc-tion increase the risk of dislocation. Hip dislocations may be corrected with closed reduction facilitated by use of a brief general anesthetic. Temporary paraly-sis can be provided by succinylcholine, if necessary, to facilitate the reduction when the hip musculature is severely contracted. Successful reduction should be confirmed radiologically prior to the patient’s emergence.