Developing care for patients with dislocation after total hip replacement

The aim of this project is to develop an accessible and inclusive care pathway for patients who experience dislocation after having their hip replaced.

Hip replacement is a common operation. It’s performed to relieve pain and improve function. Eighty per cent of replacements last at least 20 years and 90 per cent of patients report experiencing less pain and better movement after surgery. However, approximately two per cent of people who undergo a hip replacement are affected by dislocation.

Dislocation is when the head of the prosthetic femoral component comes out of its socket in the pelvis. This is very painful and requires immediate treatment, which typically involves the hip being put back in its socket. This happens under sedation or general anaesthetic.

The impact of dislocation is substantial. The dislocation event itself is extremely painful, traumatic and distressing for patients. It can have a long-lasting, negative impact on their mental health and result in a sense of vulnerability, helplessness and loss of confidence.

Our previous qualitative work has highlighted that there is often little or no support available to patients in these situations. Our systematic review found no evaluations of interventions to support patients who experience severe post-operative complications after joint replacement.

We want to:

• Understand current service provision and the context in which the intervention will be implemented
• Explore the needs and preferences of patients who experience dislocation after hip replacement and the healthcare professionals who provide care for these patients
• Identify the potential barriers and facilitators to implementation and how the intervention could be operationalized and sustained in practice

To do this we will:

• Map current services and the context within which they are provided using an online survey
• Interview patients and healthcare professionals
• Develop a novel care pathway based on our findings