Luaran Klinis dan Tantangan Teknis Total Hip Replacement pada Pasien Muda dengan Dislokasi Panggul yang Terabaikan
DOI:
https://doi.org/10.35790/ecl.v14i2.66621Keywords:
total hip replacement; dislokasi panggul terabaikan; pasien mudaAbstract
Abstract: Neglected hip dislocation in young patients often leads to severe deformity, soft-tissue contractures, avascular necrosis, and secondary osteoarthritis. Total hip replacement (THR) has become a viable reconstructive option, although the available evidence remains limited and is primarily derived from small case series. This study aimed to evaluate the clinical and functional outcomes of THR in young patients with neglected hip dislocation. A structured search was conducted across six predetermined databases for studies published between 2015 and 2025, following PRISMA and PICOS guidelines. 18 studies met the inclusion criteria and were appraised using the OCEBM 2011 and JBI 2020 tools. Most studies reported substantial postoperative improvement, including marked pain reduction and significant increases in functional scores—particularly the Harris Hip Score, with average gains of 40–50 points. Major complications were uncommon, and uncemented THR was more frequently employed to preserve bone stock. The main surgical challenges included acetabular deformity, soft-tissue fibrosis, limb-length discrepancy, and risk of recurrent dislocation. In conclusion, THR appears effective in restoring function and improving quality of life in young patients with neglected hip dislocation, although larger prospective studies are required to strengthen the long-term evidence base.
Keywords: total hip replacement; neglected hip dislocation; young patients
Abstrak: Dislokasi panggul terabaikan pada pasien muda sering menyebabkan deformitas berat, kontraktur jaringan lunak, avaskular nekrosis, dan osteoartritis sekunder. Total hip replacement (THR) telah menjadi pilihan rekonstruksi yang layak, meskipun bukti yang ada masih terbatas dan terutama berasal dari seri kasus kecil. Penelitian ini bertujuan untuk menilai luaran klinis dan fungsional dari THR pada pasien muda dengan dislokasi panggul terabaikan. Pencarian terstruktur dilakukan pada enam basis data yang telah ditentukan untuk studi yang dipublikasikan antara tahun 2015 hingga 2025, mengikuti pedoman PRISMA dan PICOS. Terdapat 18 studi memenuhi kriteria inklusi dan dinilai menggunakan alat penilaian OCEBM 2011 dan JBI 2020. Sebagian besar studi melaporkan perbaikan pascaoperasi yang substansial, termasuk penurunan nyeri yang jelas dan peningkatan bermakna pada skor fungsional—terutama Harris Hip Score, dengan kenaikan rerata 40–50 poin. Komplikasi mayor jarang terjadi, dan THR uncemented lebih sering digunakan untuk mempertahankan cadangan tulang. Tantangan bedah utama mencakup deformitas asetabulum, fibrosis jaringan lunak, ketidaksamaan panjang tungkai, dan risiko dislokasi ulang. Simpulan penelitian ini ialah THR tampak efektif dalam memulihkan fungsi dan meningkatkan kualitas hidup pada pasien muda dengan dislokasi panggul terabaikan, meskipun studi prospektif yang lebih besar diperlukan untuk memperkuat bukti jangka panjang.
Kata kunci: total hip replacement; dislokasi panggul terabaikan; pasien muda
References
1. Sundaresh Dc, Ramanath SK, Grover A, Gadi D. Uncemented total hip replacement after two years of neglected hip dislocation with fracture of posterior column and wall of the acetabulum. Trauma Mon. 2016;21(5):e25301. Available from: https://pubmed.ncbi.nlm.nih.gov/28184362/ Doi: https://doi.org/10.5812/traumamon.25301
2. Jain M, Swaroop S, Kumar DS. Neglected posterior hip dislocation in adults presenting after one year managed successfully with single stage total hip arthroplasty: a case series. JOCR. 2021;11(6):84-8 Available from: http://www.jocr.co.in/wp/2021/06/10/jocr-2021-v11-i06-2270-fulltext/
3. Purvance I, Dusak WS, Stanu GNP, Astawa NMPD. Functional outcome after total hip replacement following 30 years neglected posterior hip dislocation: a rare case report. Int J Res Med Sci. 2020;8(3):1152. Doi: https://doi.org/10.18203/2320-6012.ijrms20200796
4. Li P, Tao F, Song W, Dong J, Qiu D, Zhou D. External fixation-assisted reduction for the treatment of neglected hip dislocations with limb length discrepancy: a retrospective study of 13 cases. BMC Musculoskeletal Disorders. 2019;20(1):621. Doi: https://doi.org/10.1186/s12891-019-3015-0
5. Drobniewski M, Gonera B, Olewnik Ł, Borowski A, Ruzik K, Triantafyllou G, et al. Challenges and long-term outcomes of cementless total hip arthroplasty in patients under 30: a 24-year follow-up study with a minimum 8-year follow-up, focused on developmental dysplasia of the hip. JCM. 2024;13(21):6591. Doi https://doi.org/10.3390/jcm13216591
6. Pironti P, Ciliberto P RA, Sirtori P, Mangiavini L. Neglected acetabular fracture with hip dislocation in a 34-year-old subject treated with total hip arthroplasty: our experience. BMJ Case Rep. 2021;14(11):e245793. Doi https://doi.org/10.1136/bcr-2021-245793
7. Ba PA, Diao S, Djiba CS. Challenges of Total arthroplasty for neglected fracture-dislocations of the hip. OJO. 2023;13(10):421–6. Doi: https://doi.org/10.4236/ojo.2023.1310041
8. Eachempati KK, Parameswaran A, Reddy AK, Chandra SekharDannana, Apsingi S, Sheth N. Technique and outcomes of Total hip arthroplasty with or without sub-trochanteric shortening osteotomy for neglected post-traumatic hip fracture-dislocations: A case-series. Journal of Clinical Orthopaedics and Trauma. 2020;11(6):1143–50. Doi: https://doi.org/10.1016/j.jcot.2020.09.022
9. Singh A, Kumar P, Singh S, Singh RN, Telagareddy K. Primary complex total hip arthroplasty in neglected anterior hip dislocation with comminuted pertrochanteric femur fracture. Arthroplast Today. 2021;10:63–7. Doi https://doi.org/10.1016/j.artd.2021.06.002
10. Kiran S, Sodagor S, Buragohain CR. Neglected posterior hip dislocation: management of an 18 years old female. Int J Health Res Medico Leg Prae. 2020;6(2):52–5. Doi: https://doi.org/10.31741/ijhrmlp.v6.i2.2020.11
11. Kumar S, Dahuja A, Narula MS, Garg S, Kaur R. Neglected hip dislocation: an unusual presentation, its management and review of the literature. Strateg Trauma Limb Reconstr. 2017;12(3):189–92. Doi: https://doi.org/10.1007/s11751-017-0285-7
12 Mahardika IG, Dusak IWS, Pramadya PN. Total hip arthroplasty in young patient after neglected hip dislocation: a rare case report and literature review. Intisari Sains Medis 2024;15(3):1349-53. Doi: https://doi.org/10.15562/ism.v15i3.2164
13. Maqbool A, Alshehri T, Altheeb SA, Qaysi AA, Maqbool MM. Neglected posterior dislocation hip post acetabulum fixation: case report. JOCR. 2024;14(6):68–72. Doi: https://doi.org/10.13107/jocr.2024.v14.i06.4506
14. Mishra D, Jain M, Tripathy SK, Singh AK, Singh AK. Neglected Anterior dislocation of hip managed with total hip arthroplasty using dual approach: a case report and review of literature. Orthop Case Rep. 2024:14(8):141-7. Doi: https://doi.org/10.13107/jocr.2024.v14.i08.4678
15. Mukherjee K, Raja DK. Restoring a near anatomical hip joint in an 18-year-old neglected hip fracture dislocation–A rare case report. Indian J Orthop. 2022;8(3):226–30. Doi: https://doi.org/10.18231/j.ijos.2022.040
16. Nana TC, Jules TM, Divine MM, Ndiformuche Z, Horline BT, Ngowo NM, et al. Neglected simultaneous bilateral asymmetric traumatic hip dislocation in a young male managed by closed reduction manoeuvres in a resource-limited setting: a case report. Trauma Case Rep. 2023;44:100782. Doi: https://doi.org/10.1016/j.tcr.2023.100782
17. Patel S, Thimmegowda RB, John R, Kumar TS, Arjun RHH. Total hip arthroplasty in neglected, obturator type, hip dislocation in a young adult–an unusual case and literature review. Arthrosc Jt Surg. 2017;4(1):50–3. Doi: https://doi.org/10.1016/j.jajs.2017.03.004
18. Prabhat V, Topno R, Behera S, Prasad VDKP. Management of posttraumatic neglected hip dislocation in adults: a case series. Ann Afr Med. 2026;25(1):165-9. Doi: https://doi.org/10.4103/aam.aam_68_25
19. Pugalenthi PV, Ramanathan S, Thanappan N, Sagar MV. A rare case of neglected unreduced posterior dislocation of hip managed with total hip arthroplasty-a case report. J Evol Med Dent Sci. 2017;6(23):1953-7. Doi: https://doi.org/10.14260/Jemds/2017/428
20. Rajput IM, Siddiqui AA, Noman M, Khan MW, Shah SBA, Ali A, et al. A study of neglected traumatic hip dislocation treated with total hip arthroplasty: The journey from miserable to a happy life. Journal of Xi’an Shiyou University. 2022;18(12):813-29. Available from: https://www.researchgate.net/profile/Muhammad-Khan 1852/publication/ 367280450_A_study_of_neglected_traumatic_hip_dislocation_treated_with_total_hip_arthroplasty_The_journey_from_miserable_to_a_happy_life/links/63c9f87ae922c50e99aab3fc/A-study-of-neglected-traumatic-hip-dislocation-treated-with-total-hip-arthroplasty-The-journey-from-miserable-to-a-happy-life.pdf
21. Senga I, Ishikura H, Kaminaga N, Sato M, Tanaka T, Tanaka S. Combined anterolateral and posterior approach in total hip arthroplasty for chronic post-traumatic hip dislocation: a case report. Cureus. 2024;16(6): e61558. Doi: https://doi.org/10.7759/cureus.61558
22. Lengkong AC, Noersasongko AD, Sunaryo HK, Rawung RB, Kambey SA, Datui A. A 5-year result of neglected posterior hip dislocation with unusual presentation of false acetabulum treat with skeletal traction followed by cemented total hip replacement: a case report. International Journal of Surgery Case Reports. 2025;126(1-4):110813. Doi: https://doi.org/10.1016/j.ijscr.2024.110813
23. García de la Blanca JC, García JC, Luengo G, Martí R, Ramos LR. Neglected dislocation in adults: a new therapeutic strategy for an uncommon condition. Geriatrics. 2023;8(6):117. Doi: https://doi.org/10.3390/geriatrics8060117
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Fadilla N. R. Sadi, Stefan A. G. P. Kambey, Angelica M. J. Wagiu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
