CARE PROVISION FOR DISLOCATION AFTER HIP ARTHROPLASTY: A UK NATIONAL SURVEY OF CURRENT PRACTICE

Dislocation of hip replacements is a serious postoperative complication that affects about 2% of patients with primary hip replacement and 9% of those with revision surgery. Dislocation can cause severe psychological, physical, economic and health impact. There is a lack of evidence describing care provision for patients with dislocated hip replacement. This study aimed to understand current NHS care provision for patients with dislocation after hip replacement. A national online survey of NHS hospitals was conducted, following local NHS Trust approval (reference CAE-158). The survey was sent to health professionals in Emergency Departments, Orthopaedics, and Physiotherapy who treat and manage patients with dislocation. Data were analysed using Microsoft Excel. 46 hospitals responded to the survey. Results show that initial treatment for dislocation of hip replacement in most hospitals involves closed reduction performed at the emergency department (ED) or theatre; and patients are commonly referred to an orthopaedic clinic for routine follow-up care afterwards. Hospitals provide physiotherapy care/rehabilitation following initial treatment. However, in most hospitals there is no standardised protocol across all care sections (Emergency, Orthopaedics, and Physiotherapy). There is also a lack of psychological support provision. Recommendations for improvement to services included having a standard care protocol and provision of emotional/psychological support for patients. Perceived barriers to optimal care provision included a lack of funding, limited staff time, need for staff training and variability in care protocols. Findings indicate a lack of psychological support, and the need for a standard care pathway for patients with dislocation. Further qualitative research is now needed to inform the development of a care pathway to optimise care for patients.