Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation.

Purpose: To test whether Crowe type is related to femoral alignment and leg length discrepancy by evaluating the preoperative lengths and coronal alignment of femurs, pelvic parameters and hip morphology of patients who underwent primary hip arthroplasty due to coxarthrosis secondary to developmental dysplasia of the hip (DDH).
Materials and Methods: Medical records of patients with coxarthrosis secondary to DDH who were treated with total hip arthroplasty at Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine between 2008 and 2017 were reviewed. The mechanical axis of lower limbs was analyzed; pelvic height and femoral and tibial lengths were measured. All femurs were classified according to the Dorr classification.
Results: A total of 97 patients were eligible for analysis and were diagnosed with unilateral DDH (n=51) or bilateral DDH (n=46). In those diagnosed with unilateral DDH, the affected pelvis, femur, and tibia were often shorter than the unaffected side. In those diagnosed with bilateral DDH, femoral and pelvic lengths were unpredictable. In the femoral coronal alignment test, data varied widely but were within normal limits. The difference in the Dorr types of femurs was significant between dysplastic and normal sides of patients with unilateral DDH (P=0.001) but not those with bilateral DDH.
Conclusion: Especially in patients with unilateral DDH, pelvic heights and femoral and tibial lengths on the affected side may be shorter compared with unaffected side regardless of the Crowe type. Femoral coronal alignment is unpredictable for both groups. Careful preoperative analyses of femoral coronal alignment and pelvic length are advised.

Purpose: We wanted to evaluate the risk factors that predispose a patient to dislocation after undergoing primary total hip arthroplasty with the transtrochanteric approach.
Materials and Methods: Between July 1995 and May 2007, 593 consecutive total hip arthroplasties using the trantrochanteric approach were performed. A matched comparative study was performed for the dislocated group(18 hips) and the non-dislocated control group(18 hips). The patient-related factors and mechanical factors were retrospectively reviewed to evaluate the risk factors for dislocation.
Results: Dislocation occurred in 18 hips(3.04%). The mean age was 57.1 years in the dislocated group and 55.2 years for all of the patients (p>0.05). Statistical analyses of the BMI, inclination and anteversion of the cup, lowering of the hip center, a leg length discrepancy, the size of the femoral head and nonunion of the greater trochanter revealed no significant differences between the two groups. Nonunion of the greater trochanter was observed in 16 hips(2.84%). The risk of dislocation was 8.5 times higher in the patients with excessive alcohol intake (p<0.05). The combination of more than 3 risk factors significantly affected the incidence of dislocation after total hip arthroplasty (p<0.05).
Conclusion: After primary total hip arthroplasty with the transtrochanteric approach, in the cohort of this study, excessive alcohol intake was the main risk factor for dislocation and a combination of risk factors contributed to dislocation.

Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.

A 4-year old female patient with a diagnosis of hereditary sensory autonomic neuropathy type IV (congenital insensitivity to pain with anhidrosis) since the age of 1 year, sustained a posterior hip dislocation. During her initial stay at the hospital, an attempt at manual reduction failed. Open reduction, capsulorrhaphy, and Salter operation were done at 36 days after the index dislocation. After the operation there was a 23-degree acetabular index, and there were several abnormal round whitish gray fibrous nodules. There was also severe wound discharge, skin abrasion, and erythema on the patient’s back and buttocks due to loss of protective sensation. After conservatively treating the wound and skin problems with prone positioning, we achieved a final acetabular index of 26 degrees. The patient did not have protective sensation in her hip joint. We were able to check for increasing instability after the index operation.