Hip Joint Dislocation

The acetabular joint, or hip joint, is the largest ball and socket joint in the body, with the femoral head (top of the leg bone) sitting inside the acetabular fossa (hip socket). When the femoral head comes out of the hip socket it is referred to as a hip dislocation. Dislocations usually occur from a forceful hit to the joint, most commonly during a car accident, and will cause stretching or tearing of the connective tissue surrounding the joint. Dislocation in the hip takes a great amount of force and it will sometimes occur together with a hip fracture, back injury, head injury or fracture in the pelvis.

When the hip is dislocated, the damage to the soft tissue that usually connects and stabilizes the hip makes the joint painful and unstable. This connective tissue includes the acetabular labrum, articular cartilage, ligaments (iliofemoral, ischiofemoral, pubofemoral, and teres) and the tendons of the stabilizing muscles (piriformis, obturator internus, obturator externus, gemellus superior and inferior, quadratus femoris, IT band, psoas, rectus femoris, tensor fascia lata, gluteus medius and minimus, adductor magnus and longus).

Dislocations are classified into two categories, anterior and posterior. Posterior dislocations are the most common. With a posterior dislocation, the affected joint is rotated internally and the leg will be noticeably shorter. An anterior dislocation is less common, and the leg will be visibly rotated externally.

Symptoms of a Hip Dislocation

• Severe pain in the hip area that worsens when you try to move your hip
• Referred pain may be felt in the knee if the IT band is damaged
• Lower back or sciatica pain if the sciatic nerve is pinched
• Difficulty walking, standing or moving your leg
• Swelling and bruising in the hip area
• A visible shortening of the leg on the affected side
• A visible change in the appearance of the hip joint

Risks of Hip Dislocation

The following situations will increase your risk of a hip dislocation:

• A previous hip replacement
• Participating in high impact sports or sports where falls occur (i.e. skiing, snowboarding, gymnastics, rugby, car racing, football)
• Factors that may increase the risk of a fall - working on a ladder, dementia or an unsteady gait
• Weakness in the hip muscles due to inactivity

Most hip dislocations occur in 16 to 40 year olds involved in high energy trauma like motor vehicle accidents. (Website Dislocation of hip "Dislocation Of Hip." En.wikipedia.org. N. p., 2018. Web. 28 May 2018.)

Treating Your Hip Dislocation

A hip dislocation is a serious medical emergency! Immediate treatment is necessary. If the dislocated hip cannot be reduced (popped back in) by using manipulation alone, immediate open surgery will be undertaken to put the joint back in place.

Once the hip joint has been put back where it should be, rehabilitation will start. Significant secondary damage may have occurred from the dislocation including complications to nearby nerves, blood vessels and protective cartilage in the joint. Most probably, the ligaments surrounding the hip joint will have been damaged - perhaps strained or even ruptured. All of these issues will determine the length of your rehabilitation. In some cases, damage to blood vessels near the hip joint can cause a loss of blood supply to the bone - this is known as osteonecrosis.

In nearly all cases of post dislocation recovery, your physician, physical therapist or surgeon will recommend a treatment recovery plan for you that will include Rest, Ice, Compression, Elevation, Stretching - basically an outline of conservative treatments. Protocols used in recovery from a hip dislocation are very similar to protocols found in hip post surgery recovery. To view more information about post operative recovery/rehabilitation of the hip, click here.

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