Patient Consent for Open Hip Dislocation Surgery

Open Hip Dislocation surgery is required to manage complex joint pathology not amenable to arthroscopic surgery. Once again the risks are same as for any form of open joint surgery. The technique of gaining open access to the hip joint is designed to not need cutting of tendon or muscle as these heal with inferior scar tissue. Instead we cut bone with the tendons and muscle left attached. As with a PAO the bone has to unite and therein lies some risk associated with non-union. Also the screws used to fix the bone (Greater Trochanter in this case) can result in some sensitivity and pain when lying on the side of the operation. Hence we do sometimes remove these a year later.

This technique is also designed to minimise the risk of loss of blood supply to the femoral head, which is somewhat tenuous, while the hip is dislicated. This can result in Avascular Necrosis of the femoral head on rare occasions. However the work required for some pathologies carries this risk inherently and the access technique does not add to this significantly.

The risk of blood loss needing transfusion in minimised with the use of a cell saver technique as outlined in PAO notes.

Infection and damage to nerve and vessel as a risk is no worse than most other open joint procedures.

Overall risk averages 2-4%.