Hip disarticulation – case series analysis and literature review

Abstract

ObjectiveTo present a retrospective study of 16 patients submitted to hip disarticulation.MethodsDuring the period of 16 years, 16 patients who underwent hip disarticulation were identified. All of them were studied based on clinical records regarding the gender, age at surgery, disarticulation cause, postoperative complications, mortality rates and functional status after hip disarticulation.ResultsHip disarticulation was performed electively in most cases and urgently in only three cases. The indications had the following origins: infection (n = 6), tumor (n = 6), trauma (n = 3), and ischemia (n = 2). The mean post-surgery survival was 200.5 days. The survival rates were 6875% after six months, 5625% after one year, and 50% after three years. The mortality rates were higher in disarticulations with traumatic (66.7%) and tumoral (60%) causes. Regarding the eight patients who survived, half of them ambulate with crutches and without prosthesis, 25% walk with limb prosthesis, and 25% are bedridden. Complications and mortality were higher in the cases of urgent surgery, and in those with traumatic and tumoral causes.ConclusionHip disarticulation is a major ablative surgery with obvious implications for limb functionality, as well as high rates of complications and mortality. However, when performed at the correct time and with proper indication, this procedure can be life-saving and can ensure the return to the home environment with a certain degree of quality of life.

Regaining Gait Using an Early Postoperative Hip Prosthesis: A Case Report of an Elderly Woman

“…Patients with vascular disease have high rates of wound complications, which often preclude the eventual fitting of the prosthesis. 4) The aforementioned findings imply that the success of prothesis fitting may be dependent on the type of underlying disease. Given that the primary disease in our case was a malignant tumor, for which wound complications are uncommon, the situation was favorable for the early initiation of prosthesis fitting.…”

Damage control hip disarticulation: two-stage operation with index creation of a large medial flap for the septic hip

“…2 A recent case study found mortality was higher in disarticulations with trauma (66.7%) versus tumorous (60%) diagnoses. 9 Similarly, the risk of postoperative infection, flap necrosis and wound dehiscence increases with emergency operation. Other known risk factors include peripheral vascular disease and previous above-knee amputation.…”

“… 2 A recent case study found mortality was higher in disarticulations with trauma (66.7%) versus tumorous (60%) diagnoses. 9 …”

A case of an elderly hip disarticulation amputee with rheumatoid arthritis who regained the ability to walk using a hip prosthesis

“…In all cases, the cause of rejection of the prosthesis was attributed to the difficulty of ambulation, intolerance to the socket, or excessive weight of the prosthesis7 ) . For HDAs including elderly people to acquire the ability to walk in the community, it is generally considered necessary for them to have few comorbidities, an adequate degree of physical fitness, and individual motivation2, 3, 9, 10, 14 ) . In the present case, it was confirmed that the physical function was sufficient before fitting the prosthesis, the control of rheumatoid arthritis was comparatively good, and the motivation for reacquiring walking was very high.…”

“…Recent reports indicate that the proportion of HDAs who attain gait function still remains low14 ) ; however, depending on the condition and type of comorbidity, a prosthetic limb can be used in the rehabilitation of HDAs in the consideration of the physical and psychological state of the patient. The present case highlights the fact that even HDAs with comorbidities can use prosthetic limbs to achieve clear goals.…”