Hip Dislocation Follow-up
- Author: Matthew Gammons, MD; Chief Editor: Sherwin SW Ho, MD more...
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Athletes recovering from hip dislocations must follow a strict physical therapy regimen to ensure complete recovery of function. Stretching and range-of-motion exercises are important early in the recovery process, advancing to walking on crutches when the patient's pain fully resolves. Strengthening exercises of the muscles around the hip are important during the rehabilitation to take stress off the injured joint. The athlete should advance his or her rehabilitation regimen over time as tolerated, with light jogging by 6-8 weeks post injury, and regain full function in high-performance athletes by 3-4 months post injury.
A number of acute and chronic complications of hip dislocations exist, not all of which can be avoided with proper medical care and strict follow-up by the injured athlete. Acutely, avoiding the sequelae of sciatic nerve damage and the existence of bony fragments and soft tissues in the joint space is important. A thorough physical examination and review of the radiographic findings are required to avoid the consequences of these conditions.
Chronic complications (eg, avascular necrosis, osteoarthritis) may not be avoided with good follow-up care. Radiographs should be obtained at the previously described intervals, and an MRI should be performed within 6 weeks post injury to evaluate for avascular necrosis (see Maintenance Phase, Other Treatment). Unfortunately, even with compliant patients, early diagnosis, early and appropriate treatment, and good follow-up, some patients develop chondrolysis, avascular necrosis, and early degenerative joint disease (DJD).
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- No literature on the prevention of hip dislocations exists.
- As these injuries are generally high-velocity injuries, the success of any prevention program, other than high-risk activity avoidance, would be unlikely.
The amount of energy to the hip and the associated trauma during the initial injury are the most important factors related to prognosis. Fortunately, sports-related hip dislocations are usually caused by less energy than is generated during motor vehicle accidents. The prognosis is best when the hip is reduced as soon as possible, preferably less than 12 hours post injury. The prognosis is also dependent upon the amount of related fractures or damage associated with the joint. The less associated damage to the surrounding structures there is, the better the prognosis for full recovery.
Although no studies on the prevention of hip dislocation exist, athletes that participate in high-performance activities need to understand the importance of performing proper warm-up techniques before competition and maintaining good overall flexibility and strength. These attributes are especially important during athletic events (eg, American football, rugby, alpine skiing) when high speeds can generate relatively large forces, which can cause serious injuries to competing athletes.
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