Hip Dislocation Follow-up

  • Author: Matthew Gammons, MD; Chief Editor: Sherwin SW Ho, MD   more...
 
Updated: Feb 1, 2012
 

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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.

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Complications

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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Prevention

  • 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.
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Prognosis

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.

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Education

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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Contributor Information and Disclosures
Author

Matthew Gammons, MD  Assistant Clinical Professor, Department of Family and Community Medicine, Medical College of Wisconsin; Medical Director, Castleton State College; Consulting Staff, Vermont Orthopaedic Clinic and Killington Medical Clinic

Matthew Gammons, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and American Society of Mechanical Engineers

Disclosure: Nothing to disclose.

Specialty Editor Board

Gerard A Malanga, MD  Director of Pain Management, Overlook Hospital; Director of PM&R Sports Medicine Fellowship, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Fellow, American College of Sports Medicine

Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Institute of Ultrasound in Medicine, International Spine Intervention Society, and North American Spine Society

Disclosure: Cephalon Honoraria Speaking and teaching; Endo Honoraria Speaking and teaching; Genzyme Honoraria Speaking and teaching; Prostakan Honoraria Speaking and teaching; Pfizer Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD  Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and Herodicus Society

Disclosure: Breg, Inc. Consulting fee Consulting; Biomet, Inc. Consulting fee Consulting; GMV, Inc. Arthroscopy Simulator Evaluation and teaching; Smith and Nephew Grant/research funds Fellowship funding; DJ Ortho Grant/research funds Course funding; Athletico Physical Therapy Grant/research funds Course, research funding

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Alexander Zlidenny, MD, and Federico E Vaca, MD, FACEP, to the development and writing of this article.

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