Long-Term Outcome of Total Hip Replacement Luxation Addressed without Modification of Implant Size or Position

Introduction: To report long-term outcome of total hip replacement (THR) luxation addressed only by reduction.

Materials and Methods: Dogs that developed hip luxation following THR (Biomedtrix) and treated with reduction without additional change in implant positioning or size were included. Decision was made on interpretation of implant position on postoperative radiographs along with evaluation of the hip range-of-motion and laxity following either open or closed reduction.

Results: Five dogs (6 THR) met the inclusion criteria. Four luxations were treated with open reduction and two with closed reduction. Hobbles were placed for 4 weeks on all THR with ventral luxations. One dorsal luxation was treated with combination of ilio-femoral suture and Ehmer sling. Median follow-up time after reduction was 1221 days (737–1,724). Two THR re-luxated ventrally at 292 and 987 days postreduction. A third dog had intermittent ventral hip subluxation identified under sedation.

Discussion/Conclusion: Reduction of luxation following THR without intervention to adjust implant position or size was associated with a high recurrence rate of luxation. No further complications were observed after subsequent implant position revision in two cases suggesting early change of cup position may have prevented further luxation. Re-luxation following reduction occurred late after reduction. Postoperative external coaptation may have contributed to earlier periarticular stability, delaying occurrence of impingement associated luxation at extreme angles. Long-term follow-up is warranted when assessing outcome of THR revision. Three dogs did not have further long-term complications. This chance of success should be considered against the risk associated with surgical implant revision.

Acknowledgments: There was no proprietary interest or funding provided for this project.

Publication History

Article published online:
11 September 2023