Recurrent Posterior Dislocation of the Hip Treated with Periacetabular Osteotomy

Abstract

Recurrent traumatic dislocation of the hip is rarely observed. We present the case of a patient who had traumatic hip dislocation associated with a dysplastic acetabulum and recurrent instability who was managed with capsular repair and periacetabular osteotomy to enhance the stability of the joint. At the time of the latest follow-up, the patient had an excellent clinical result and returned to his occupation as a skiing instructor. This case report was approved by our institutional review board. The patient was informed that data concerning this case would be submitted for publication. In April 2005, a twenty-year-old man with no previous hip problems fell down while snowboarding and sustained a posterior dislocation of the left hip. At a nearby hospital, radiographs of the pelvis showed a posterior dislocation of the hip joint without fracture (an Epstein-Thompson type-I dislocation1) (Figs. 1-A and 1-B). The patient was immediately taken to the operating room for a closed reduction of the left hip under general anesthesia. Postoperatively, he was placed in skin traction for one week. After three weeks, he was allowed to walk with crutches and was discharged from the hospital. After six weeks, he returned to full weight-bearing and progressed gradually to activities as tolerated. Three months after the first injury, he had a second dislocation of the same hip when he fell down while skateboarding (see Appendix). He was taken to the hospital and was managed with the same protocol of closed reduction and progressive weight-bearing. After the second injury, the patient had no other episodes of dislocation for two years. In August 2007, while he was playing baseball, he pivoted on the left leg and dislocated the left hip for the third time. He was taken to a nearby hospital and was managed with closed reduction under sedation. He …