Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Hip Dislocation Follow-up

  • Author: Matthew Gammons, MD; Chief Editor: Sherwin SW Ho, MD  more...
 
Updated: Mar 27, 2014
 

Return to Play

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.

Next

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).

Previous
Next

Prevention

See the list below:

  • 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.
Previous
Next

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.

Previous
Next

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.

Previous
 
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, American Society of Mechanical Engineers

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

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, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

Gerard A Malanga, MD Founder and Partner, New Jersey Sports Medicine, LLC and New Jersey Regenerative Institute; Director of Research, Atlantic Health; Clinical Professor, Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Fellow, American College of Sports Medicine

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

Disclosure: Received honoraria from Cephalon for speaking and teaching; Received honoraria from Endo for speaking and teaching; Received honoraria from Genzyme for speaking and teaching; Received honoraria from Prostakan for speaking and teaching; Received consulting fee from Pfizer for speaking and teaching.

Acknowledgements

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.

References
  1. Mitchell JC, Giannoudis PV, Millner PA, Smith RM. A rare fracture-dislocation of the hip in a gymnast and review of the literature. Br J Sports Med. 1999 Aug. 33(4):283-4. [Medline]. [Full Text].

  2. Rockwood CA, Green DP, Bucholz PW, Heckman JD, eds. Fractures and dislocations of the hip. Fractures in Adults. 4th ed. Philadelphia, Pa: Lippincott-Raven; 1996. Vol 2: 1756-1803.

  3. Yates C, Bandy WD, Blasier RD. Traumatic dislocation of the hip in a high school football player. Phys Ther. 2008 Jun. 88(6):780-8. [Medline].

  4. Liporace FA, Dasti UR, Raiszadeh K. Ipsilateral anterior then irreducible posterior hip dislocation without fracture: a case report. J Orthop Trauma. 2008 May-Jun. 22(5):363-7. [Medline].

  5. Tennent TD, Chambler AF, Rossouw DJ. Posterior dislocation of the hip while playing basketball. Br J Sports Med. 1998 Dec. 32(4):342-3. [Medline]. [Full Text].

  6. Pallia CS, Scott RE, Chao DJ. Traumatic hip dislocation in athletes. Curr Sports Med Rep. 2002 Dec. 1(6):338-45. [Medline].

  7. Matsumoto K, Sumi H, Sumi Y, Shimizu K. An analysis of hip dislocations among snowboarders and skiers: a 10-year prospective study from 1992 to 2002. J Trauma. 2003 Nov. 55(5):946-8. [Medline].

  8. Collins J, Trulock S, Chao D. Field management and rehabilitation of an acute posterior hip dislocation in a professional football player. Pro Football Athletic Trainer. Summer 2001. 19(1):1,3. [Full Text].

  9. Schmidt GL, Sciulli R, Altman GT. Knee injury in patients experiencing a high-energy traumatic ipsilateral hip dislocation. J Bone Joint Surg Am. 2005 Jun. 87(6):1200-4. [Medline].

  10. Kovacevic D, Mariscalco M, Goodwin RC. Injuries about the hip in the adolescent athlete. Sports Med Arthrosc. 2011 Mar. 19(1):64-74. [Medline].

  11. Blankenbaker DG, De Smet AA. Hip injuries in athletes. Radiol Clin North Am. 2010 Nov. 48(6):1155-78. [Medline].

  12. Rancan M, Esser MP, Kossmann T. Irreducible traumatic obturator hip dislocation with subcapital indentation fracture of the femoral neck: a case report. J Trauma. 2007 Jun. 62(6):E4-6. [Medline].

  13. Cooper DE, Warren RF, Barnes R. Traumatic subluxation of the hip resulting in aseptic necrosis and chondrolysis in a professional football player. Am J Sports Med. 1991 May-Jun. 19(3):322-4. [Medline].

  14. Yang EC, Cornwall R. Initial treatment of traumatic hip dislocations in the adult. Clin Orthop Relat Res. 2000 Aug. 377:24-31. [Medline].

  15. Dreinhofer KE, Schwarzkopf SR, Haas NP, Tscherne H. Isolated traumatic dislocation of the hip. Long-term results in 50 patients. J Bone Joint Surg Br. 1994 Jan. 76(1):6-12. [Medline]. [Full Text].

  16. Hendey GW, Avila A. The Captain Morgan technique for the reduction of the dislocated hip. Ann Emerg Med. 2011 Dec. 58(6):536-40. [Medline].

  17. Hillyard RF, Fox J. Sciatic nerve injuries associated with traumatic posterior hip dislocations. Am J Emerg Med. 2003 Nov. 21(7):545-8. [Medline].

  18. Seltzer SE, Weissman BN, Braunstein EM, et al. Indications for CT scanning in orthopedic disorders of hip. Orthop Rev. 1983. 12:29-40.

  19. Epstein HC. Posterior fracture-dislocations of the hip: comparison of open and closed methods of treatment in certain types. J Bone Joint Surg Am. Dec 1961. 43A:1079-98. [Full Text].

  20. Cash DJ, Nolan JF. Avascular necrosis of the femoral head 8 years after posterior hip dislocation. Injury. 2007 Jul. 38(7):865-7. [Medline].

  21. Grissom L, Harcke HT, Thacker M. Imaging in the surgical management of developmental dislocation of the hip. Clin Orthop Relat Res. 2008 Apr. 466(4):791-801. [Medline].

  22. Hartofilakidis G, Yiannakopoulos CK, Babis GC. The morphologic variations of low and high hip dislocation. Clin Orthop Relat Res. 2008 Apr. 466(4):820-4. [Medline].

  23. Jacob JR, Rao JP, Ciccarelli C. Traumatic dislocation and fracture dislocation of the hip. A long-term follow-up study. Clin Orthop Relat Res. 1987 Jan. 214:249-63. [Medline].

  24. Kapicioglu MI, Korkusuz F. Diagnosis of developmental dislocation of the hip by sonospectrography. Clin Orthop Relat Res. 2008 Apr. 466(4):802-8. [Medline].

  25. Kohler R, Seringe R. [Congenital dislocation of the hip: current concepts as a preliminary for diagnosis and treatment] [French]. Rev Chir Orthop Reparatrice Appar Mot. 2008 May. 94(3):217-227. [Medline].

  26. Pascarella R, Maresca A, Cappuccio M, Reggiani LM, Boriani S. Asymmetrical bilateral traumatic fracture dislocation of the hip: a report of two cases. Chir Organi Mov. 2008 May 26. epub ahead of print. [Medline].

  27. Weber M, Ganz R. Recurrent traumatic dislocation of the hip: report of a case and review of the literature. J Orthop Trauma. 1997 Jul. 11(5):382-5. [Medline].

Previous
Next
 
Normal anteroposterior (AP) pelvis radiograph.
Right posterior hip dislocation in a young woman following a high-speed motor vehicle collision (MVC).
Fracture-dislocation of the right hip. The bony fragments are likely part of the acetabulum.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.