Orthopedic Surgeon Orders Fall Precautions After Patient’s Accident

This defense case involves a sixty-two-year-old male patient who underwent a left hip arthroplasty. On postoperative day three, prior to transfer to a step-down facility, the patient alleged that he fell when walking to the restroom. The nurse charted and maintained that the patient never fell but, instead, that he became weak between the bathroom and bed and was gently guided to the floor. The physician was informed of the incident and told the nurse to let the receiving facility know that fall precautions were necessary. The patient was transferred to a long-term care facility for rehabilitation and complained of pain for the following three days. He was then transferred back to the hospital, where X-rays revealed dislocation of the new, prosthetic hip. A closed reduction was performed to place the man’s hip back into place.

Question(s) For Expert Witness

1. Can a hip dislocation after hip arthroplasty occur without a fall?

Expert Witness Response E-006422

Hip replacement surgery is usually very successful; pain relief and increased ability to perform routine activities are among the best benefits of this procedure. Unfortunately, hip replacements have some potential complications. These complications are uncommon, but they do occur--sometimes in unforeseen circumstances but sometimes with relatively little or no movement. Among the most frequently seen complications of hip replacement surgery is dislocation of the hip replacement. Hip replacement dislocations occur in about 4% of first-time surgeries, and about 15% of revision hip replacements. So, it is very well possible that this hip was dislocated without a fall.