{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:15:31Z","timestamp":1789020931489,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Prosthetic hip dislocation remains one of the most common complications following total hip arthroplasty (THA), often managed with closed reduction under procedural sedation. This study aimed to evaluate how sedation strategy, procedural location, and patient-specific factors influence the success of closed reduction in prosthetic hip dislocations. We hypothesized that higher body mass index (BMI), use of dissociative agents, and emergency department (ED) setting would be associated with lower reduction success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed of adults presenting with prosthetic hip dislocations to two tertiary centers (2014\u20132024). Demographic, procedural, and pharmacologic data were abstracted from medical records. Logistic regression was used to assess associations between reduction success and location, sedation class, BMI, and procedural duration. Receiver operating characteristic (ROC) analysis identified thresholds for escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 201 reduction encounters (111 patients), overall success was 73.1% (ED 54.3%, OR 94.4%). In multivariable analysis, non-ED location was the dominant predictor of success (OR 38.4, 95% CI 8.0\u2013184;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while no medication class independently predicted outcome. Procedure duration was inversely associated with success in the ED (OR 0.88 per minute;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047), with an escalation threshold of approximately 25\u00a0min (AUC 0.72). BMI, age, comorbidities, and implant type were not associated with reduction success.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated reduction location was the dominant predictor of success, with non-ED settings demonstrating substantially higher odds of achieving closed reduction. Longer procedure duration was inversely associated with success, suggesting that protracted or repeated attempts should prompt early operative escalation. Standardized sedation protocols, adequate muscle relaxation, and algorithmic triage for high-risk cases may enhance success rates and reduce resource utilization in the management of prosthetic hip dislocations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-025-04589-7","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T12:04:03Z","timestamp":1762949043000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of failed reduction after prosthetic hip dislocation"],"prefix":"10.1007","volume":"36","author":[{"given":"Nicholas","family":"Frappa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danil","family":"Chernov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan G.","family":"Papalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Fuller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Lutnick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Alben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"issue":"1","key":"4589_CR1","doi-asserted-by":"publisher","first-page":"128","DOI":"10.2106\/JBJS.H.00155","volume":"91","author":"KJ Bozic","year":"2009","unstructured":"Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ (2009) The epidemiology of revision total hip arthroplasty in the united States. J Bone Joint Surg Am 91(1):128\u2013133. https:\/\/doi.org\/10.2106\/JBJS.H.00155","journal-title":"J Bone Joint Surg Am"},{"issue":"4 Suppl 1","key":"4589_CR2","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.arth.2006.12.111","volume":"22","author":"PD Patel","year":"2007","unstructured":"Patel PD, Potts A, Froimson MI (2007) The dislocating hip arthroplasty: prevention and treatment. J Arthroplasty 22(4 Suppl 1):86\u201390. https:\/\/doi.org\/10.1016\/j.arth.2006.12.111","journal-title":"J Arthroplasty"},{"key":"4589_CR3","doi-asserted-by":"publisher","unstructured":"Minelli M, Kon E, D\u2019Addona A, Rosolani M, Di Matteo B, Della Rocca F (2025) Minimum five years outcomes of modular dual mobility in primary total hip arthroplasty: a systematic review. Int Orthop Published Online April 7. https:\/\/doi.org\/10.1007\/s00264-025-06507-2","DOI":"10.1007\/s00264-025-06507-2"},{"issue":"10","key":"4589_CR4","doi-asserted-by":"publisher","first-page":"e70928","DOI":"10.7759\/cureus.70928","volume":"16","author":"PA Saxena","year":"2024","unstructured":"Saxena PA, Amanullah N, Rajagopalan S, Ashwood N (2024) Outcomes and management of dislocated hip hemiarthroplasty. Cureus 16(10):e70928 Published 2024 Oct 6. https:\/\/doi.org\/10.7759\/cureus.70928","journal-title":"Cureus"},{"issue":"1 Suppl","key":"4589_CR5","doi-asserted-by":"publisher","first-page":"S25","DOI":"10.1016\/j.otsr.2013.11.008","volume":"100","author":"JL Charissoux","year":"2014","unstructured":"Charissoux JL, Asloum Y, Marcheix PS (2014) Surgical management of recurrent dislocation after total hip arthroplasty. Orthop Traumatol Surg Res 100(1 Suppl):S25\u2013S34. https:\/\/doi.org\/10.1016\/j.otsr.2013.11.008","journal-title":"Orthop Traumatol Surg Res"},{"issue":"3","key":"4589_CR6","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.jemermed.2017.12.002","volume":"54","author":"M Gottlieb","year":"2018","unstructured":"Gottlieb M (2018) Hip dislocations in the emergency department: A review of reduction techniques. J Emerg Med 54(3):339\u2013347. https:\/\/doi.org\/10.1016\/j.jemermed.2017.12.002","journal-title":"J Emerg Med"},{"issue":"3","key":"4589_CR7","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.ocl.2016.02.002","volume":"47","author":"MJ Beebe","year":"2016","unstructured":"Beebe MJ, Bauer JM, Mir HR (2016) Treatment of hip dislocations and associated injuries: current state of care. Orthop Clin North Am 47(3):527\u2013549. https:\/\/doi.org\/10.1016\/j.ocl.2016.02.002","journal-title":"Orthop Clin North Am"},{"issue":"1","key":"4589_CR8","doi-asserted-by":"publisher","first-page":"76","DOI":"10.5811\/westjem.2013.7.15616","volume":"15","author":"JE Dela Cruz","year":"2014","unstructured":"Dela Cruz JE, Sullivan DN, Varboncouer E et al (2014) Comparison of procedural sedation for the reduction of dislocated total hip arthroplasty. West J Emerg Med 15(1):76\u201380. https:\/\/doi.org\/10.5811\/westjem.2013.7.15616","journal-title":"West J Emerg Med"},{"issue":"5","key":"4589_CR9","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/j.annemergmed.2010.11.030","volume":"57","author":"SM Green","year":"2011","unstructured":"Green SM, Roback MG, Kennedy RM, Krauss B (2011) Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med 57(5):449\u2013461. https:\/\/doi.org\/10.1016\/j.annemergmed.2010.11.030","journal-title":"Ann Emerg Med"},{"issue":"2","key":"4589_CR10","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.jemermed.2021.10.011","volume":"63","author":"S Kruggel","year":"2022","unstructured":"Kruggel S, Mishler A, Sullivan L (2022) A safety comparison of Single-Agent Methohexital, Ketamine, or Propofol for musculoskeletal procedural sedation in the emergency department. J Emerg Med 63(2):290\u2013295. https:\/\/doi.org\/10.1016\/j.jemermed.2021.10.011","journal-title":"J Emerg Med"},{"issue":"6","key":"4589_CR11","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/j.1553-2712.2010.00776","volume":"17","author":"JR Miner","year":"2010","unstructured":"Miner JR, Gray RO, Bahr J, Patel R, McGill JW (2010) Randomized clinical trial of Propofol versus ketamine for procedural sedation in the emergency department. Acad Emerg Med 17(6):604\u2013611. https:\/\/doi.org\/10.1111\/j.1553-2712.2010.00776","journal-title":"Acad Emerg Med"},{"issue":"9","key":"4589_CR12","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1111\/acem.12737","volume":"22","author":"JW Yan","year":"2015","unstructured":"Yan JW, McLeod SL, Iansavitchene A (2015) Ketamine-Propofol versus Propofol alone for procedural sedation in the emergency department: A systematic review and Meta-analysis. Acad Emerg Med 22(9):1003\u20131013. https:\/\/doi.org\/10.1111\/acem.12737","journal-title":"Acad Emerg Med"},{"issue":"1","key":"4589_CR13","doi-asserted-by":"publisher","first-page":"133","DOI":"10.5114\/aoms\/92214","volume":"18","author":"V Janz","year":"2021","unstructured":"Janz V, Wassilew GI, Putzier M, Kath G, Perka CF (2021) Identification of risk factors for treatment failure of closed reduction and abduction bracing after first-time total hip arthroplasty dislocation. Arch Med Sci 18(1):133\u2013140 Published 2021 Jan 8. https:\/\/doi.org\/10.5114\/aoms\/92214","journal-title":"Arch Med Sci"},{"issue":"1","key":"4589_CR14","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.annemergmed.2006.08.002","volume":"49","author":"EV Willman","year":"2007","unstructured":"Willman EV, Andolfatto G (2007) A prospective evaluation of ketofol (ketamine\/propofol combination) for procedural sedation and analgesia in the emergency department. Ann Emerg Med 49(1):23\u201330. https:\/\/doi.org\/10.1016\/j.annemergmed.2006.08.002","journal-title":"Ann Emerg Med"},{"issue":"3","key":"4589_CR15","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.bja.2023.11.050","volume":"132","author":"S Sharif","year":"2024","unstructured":"Sharif S, Kang J, Sadeghirad B et al (2024) Pharmacological agents for procedural sedation and analgesia in the emergency department and intensive care unit: a systematic review and network meta-analysis of randomised trials. Br J Anaesth 132(3):491\u2013506. https:\/\/doi.org\/10.1016\/j.bja.2023.11.050","journal-title":"Br J Anaesth"},{"issue":"12","key":"4589_CR16","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1097\/pec.0b013e31815c9df6","volume":"23","author":"GQ Sharieff","year":"2007","unstructured":"Sharieff GQ, Trocinski DR, Kanegaye JT, Fisher B, Harley JR (2007) Ketamine-propofol combination sedation for fracture reduction in the pediatric emergency department. Pediatr Emerg Care 23(12):881\u2013884. https:\/\/doi.org\/10.1097\/pec.0b013e31815c9df6","journal-title":"Pediatr Emerg Care"},{"issue":"5","key":"4589_CR17","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.annemergmed.2010.08.032","volume":"57","author":"A Shah","year":"2011","unstructured":"Shah A, Mosdossy G, McLeod S, Lehnhardt K, Peddle M, Rieder M (2011) A blinded, randomized controlled trial to evaluate ketamine\/propofol versus ketamine alone for procedural sedation in children. Ann Emerg Med 57(5):425\u201333e2. https:\/\/doi.org\/10.1016\/j.annemergmed.2010.08.032","journal-title":"Ann Emerg Med"},{"key":"4589_CR18","unstructured":"Siddiqui BA, Kim PY, Anesthesia Stages [Updated 2023 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557596\/"},{"issue":"2","key":"4589_CR19","doi-asserted-by":"publisher","first-page":"111252","DOI":"10.1016\/j.injury.2023.111252","volume":"55","author":"J Tarchichi","year":"2024","unstructured":"Tarchichi J, Daher M, Sakr I et al (2024) Anterior hip dislocation: A current concepts review and proposal of management algorithm. Injury 55(2):111252. https:\/\/doi.org\/10.1016\/j.injury.2023.111252","journal-title":"Injury"},{"issue":"3","key":"4589_CR20","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1007\/s11999-012-2512-3","volume":"471","author":"JM Elkins","year":"2013","unstructured":"Elkins JM, Daniel M, Pedersen DR et al (2013) Morbid obesity May increase dislocation in total hip patients: a Biomechanical analysis. Clin Orthop Relat Res 471(3):971\u2013980. https:\/\/doi.org\/10.1007\/s11999-012-2512-3","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"4589_CR21","doi-asserted-by":"publisher","first-page":"161","DOI":"10.5371\/hp.2022.34.3.161","volume":"34","author":"N Cochrane","year":"2022","unstructured":"Cochrane N, Ryan S, Kim B, Wu M, O\u2019Donnell J, Seyler T (2022) Total hip arthroplasty in morbidly obese: does a strict body mass index cutoff yield meaningful change? Hip Pelvis 34(3):161\u2013171. https:\/\/doi.org\/10.5371\/hp.2022.34.3.161","journal-title":"Hip Pelvis"},{"issue":"5","key":"4589_CR22","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1177\/11207000241251696","volume":"34","author":"S Waseem","year":"2024","unstructured":"Waseem S, Ngu A, Patel J, ORCA Research Collaborative (2024) Emergency department closed reduction of dislocated THR: the REDDTHR prospective Multi-centre study. Hip Int 34(5):633\u2013640. https:\/\/doi.org\/10.1177\/11207000241251696","journal-title":"Hip Int"},{"issue":"11","key":"4589_CR23","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1136\/emj.2003.011809","volume":"22","author":"SJ Frymann","year":"2005","unstructured":"Frymann SJ, Cumberbatch GL, Stearman AS (2005) Reduction of dislocated hip prosthesis in the emergency department using conscious sedation: a prospective study. Emerg Med J 22(11):807\u2013809. https:\/\/doi.org\/10.1136\/emj.2003.011809","journal-title":"Emerg Med J"},{"key":"4589_CR24","doi-asserted-by":"publisher","first-page":"95","DOI":"10.2147\/DHPS.S278507","volume":"13","author":"M Veen","year":"2021","unstructured":"Veen M, van der Zwaal P, van der Linden MC (2021) Documentation of procedural sedation by emergency physicians. Drug Healthc Patient Saf 13:95\u2013100 Published 2021 Apr 6. https:\/\/doi.org\/10.2147\/DHPS.S278507","journal-title":"Drug Healthc Patient Saf"}],"container-title":["European Journal of Orthopaedic Surgery &amp; Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-025-04589-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-025-04589-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-025-04589-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T12:04:04Z","timestamp":1762949044000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00590-025-04589-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4589"],"URL":"https:\/\/doi.org\/10.1007\/s00590-025-04589-7","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"8 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"10"}}