2026-04-13T07:49:50Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/72882025-10-24T10:26:31Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Pujol Alarcón, Oriol author Mimendia Sancho, Iñaki author Martin-Dominguez, Lidia author Amat Mateu, Carles author Barro Ojeda, Victor author 2022-03-31T10:49:29Z 2022-03-31T10:49:29Z 2021-03 Luxació; Mobilitat dual; Encefalopatia hepàtica Dislocación; Movilidad dual; Encefalopatía hepática Dislocation; Dual mobility; Hepatic encephalopathy Introduction and importance Dislocation is a severe complication after total hip arthroplasty (THA). It is one of the most common reasons for failure and revision surgery. This is the first case of a documented simultaneous bilateral dual mobility (DM) THA dislocation. Case presentation A forty-nine-year-old man presented with bilateral hip pain, immobility and deformity. X-ray images demonstrated simultaneous bilateral posterior THA dislocation. Previously, the patient had presented atraumatic dislocations recurrently. When he was thoroughly re-interrogated, he complained of uncontrolled and generalized muscle contractions, which were compatible with myoclonus due to hepatic encephalopathy (HE). Multidisciplinary treatment was performed satisfactorily to control myoclonus symptomatology and to prevent dislocation. Clinical discussion Patient’s most important risk factor was a neuromuscular disorder, which we initially gave little notice and undervalued. HE is a serious but reversible syndrome, observed in patients with liver dysfunction. It leads to a wide spectrum of neuropsychiatric abnormalities. Management is based on prevention of episodes, avoiding the underlying triggers. Due to the high risk for dislocation of our patient, we decided to use DM cups bilaterally. This system has demonstrated lower rates of dislocation. Conclusion This case report reminds us that a careful evaluation through meticulous history and physical examination are mandatory when faced with recurrent instability. Furthermore, prevention of dislocation is vastly preferable to treating this challenging complication. High-risk patients should be identified, and appropriate surgical approach, technique and implants have to be collectively used to reach a strategy that mitigates and ideally prevents dislocation. http://hdl.handle.net/11351/7288 Encefalopatia hepàtica Artroplàstia total de maluc - Complicacions Articulació coxofemoral - Luxació ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Orthopedic Procedures::Arthroplasty::Arthroplasty, Replacement::Arthroplasty, Replacement, Hip Other subheadings::Other subheadings::Other subheadings::/adverse effects DISEASES::Wounds and Injuries::Joint Dislocations::Wounds and Injuries::Hip Dislocation DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Brain Diseases, Metabolic::Hepatic Encephalopathy TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos ortopédicos::artroplastia::artroplastia de sustitución::artroplastia de sustitución de cadera Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ENFERMEDADES::heridas y lesiones::luxaciones articulares::heridas y lesiones::luxación de la cadera ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::enfermedades cerebrales metabólicas::encefalopatía hepática Simultaneous bilateral dual mobility total hip arthroplasty dislocation in a patient with hepatic encephalopathy: A case report