Emergency Department closed reduction of dislocated THR: the REDDTHR Prospective Multi-centre Study.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-09-01 Epub Date: 2024-05-31 DOI:10.1177/11207000241251696
Saima Waseem, Albert Ngu, Jason Patel
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引用次数: 0

Abstract

Introduction: Dislocation is a potentially devastating complication severely affecting outcomes post total hip arthroplasty (THR). We aimed to assess the efficacy and safety of closed reduction of a dislocated THR within the Emergency Department (ED).

Methods: A prospective multi-centre study was conducted over a 1-year period from November 2020 to December 2021 within 10 hospitals based in the East of England. Collected data included patient demographics, agent used for sedation, hospital length of stay, implant type and discharge destination. Patients were analysed according to whether successful reduction was performed in the ED or not. The primary outcome was length of stay, with secondary outcomes including discharge destination and pain post-procedure.

Results: We studied 99 patients with an average age of 77.02 years, with 39 (39%) patients being male. 11 patients had revision hip replacements and 88 patients had primary THRs. 57 (57.6%) underwent closed reduction in the Emergency department, of which 44 (77.2%) were successful. Successful closed reduction was significantly associated with lower patient age (p = 0.02), lower American society of Anesthesiologists (ASA) score (p < 0.01) and use of propofol (p < 0.01). Patients who underwent successful ED closed reduction had a lower hospital stay than those that did not (1 vs. 3 days, p < 0.01), however there was no significant difference in discharge destination.

Conclusions: When adopted, success following closed reduction is increased in younger patients with less comorbidities following use of propofol sedation. Following sedation, patients have a significantly shorter hospital stay. Increasing uptake of closed reduction of THR dislocation within the ED in suitable patients with evidence-based best practice protocols will maximise patient outcomes whilst allowing efficient resource utilisation.

急诊室全车脱位闭合复位术:REDDTHR 前瞻性多中心研究。
简介:脱位是一种潜在的破坏性并发症,严重影响全髋关节置换术(THR)后的疗效。我们旨在评估在急诊科(ED)内对脱位的全髋关节置换术进行闭合复位的有效性和安全性:从 2020 年 11 月到 2021 年 12 月,我们在英格兰东部的 10 家医院开展了一项为期 1 年的前瞻性多中心研究。收集的数据包括患者的人口统计学特征、镇静剂、住院时间、植入物类型和出院目的地。根据患者是否在急诊室成功实施减张术进行分析。主要结果是住院时间,次要结果包括出院目的地和术后疼痛:我们共研究了 99 名患者,平均年龄为 77.02 岁,其中 39 名(39%)患者为男性。11名患者接受了翻修髋关节置换术,88名患者接受了初次髋关节置换术。57例(57.6%)患者在急诊科接受了闭合复位术,其中44例(77.2%)手术成功。闭合复位术的成功与患者年龄较小(P = 0.02)、美国麻醉医师协会(ASA)评分较低(P P P 结论:采用异丙酚镇静后,合并症较少的年轻患者闭合复位的成功率更高。使用镇静剂后,患者的住院时间明显缩短。在急诊室对合适的患者采用以证据为基础的最佳实践方案,增加THR脱位闭合复位术的使用率,将最大限度地提高患者的治疗效果,同时实现资源的有效利用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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