Do you have concerns about hip displacement? Or you have had a hip dislocation and you are seeking specific information on causes, treatment and recovery time?
As a diagnostic radiographer I have x-rayed and assisted theatre cases during hip reductions and I do feel your concerns.
Here I will summarise the answers to the most frequently asked questions on this topic drawing from my experience and medical studies.
Happy reading!😀
Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏
Last updated: April 2024. Written by Juliet Semakula, diagnostic radiographer.
Disclaimer: no affiliate links.
▶️What is a hip dislocation in simple terms?
When you dislocate your hip, it means the femoral head is pushed either backward out of the socket, or forward.
During my years of practice, I have seen 90% of hip dislocation where the femur is pushed out of the socket in a backward direction. This is called a posterior dislocation.
When the femur slips out of its socket in a forward direction, this is an anterior dislocation.
While a central dislocation always occurs with Acetabulum Fracture.
When you dislocate your hip, you should expect the ligaments, nerves, labrum, muscles, and other soft tissues holding the bones to be damaged as well.
▶️Is hip dislocation an emergency?
A hip dislocation can be a medical emergency. Seek medical care as soon as possible and do not do the following until you see a doctor.
🔶Do not try to move the injured leg, try to keep warm with a blanket until you see a doctor.
🔶Keep your knees and toes pointed forward when you sit in a chair, walk, or stand.
🔶Do not sit with your legs crossed.
🔶Do not bend at the waist more than 90º. Be careful when leaning or when moving in bed to keep your legs as straight ahead as possible.
▶️What are the symptoms of a dislocated hip replacement?
🔷You experience severe hip pain or pain around the groin.
🔷You may hear snapping, clicking, or popping sounds or sensations in any part of the hip.
🔷You cannot put weight on your foot on the ground, not even move the leg.
🔷Your hip will be locked in position, the foot turned completely inward, making the leg appear shorter.
Can a dislocated hip go unnoticed?
When your hip dislocates you will notice if you have all the above symptoms, but you will only be able to confirm by seeing a doctor and being well examined.
▶️How do you really know if you’ve dislocated your hip?
When you have had a hip replacement fear may arise when you start experiencing some pain or sudden movement after a few days of the operation.
You may think it is a sign of a problem. Rest assured these signs are not sufficient to suggest a replacement dislocation.
When your hip dislocates:
🔷It will be very painful; you will not be in position to move your leg and if there is nerve damage you will lose feelings in your foot and ankle area.
🔷You will not be able to walk, and your leg will be deformed.
It is possible to experience very intensive pain without necessarily dislocating your hip. Pain alone is not a reliable indicator .So your doctor will examine your hip before x-rays are requested.
▶️Examination and diagnosis of a hip dislocation.
Hip dislocation is the only injury an orthopaedic surgeon can often diagnose without the help of x-rays just by looking at the position of your leg.
However, x-rays and likely CT scan will always be needed to rule out any additional fractures in the hip or femur and for treatment planning.
X-rays will show which direction your hip is dislocated and any other associated injuries, and it gives the surgeon direction on how to reduce the hip back in the joint.
▶️What is the risk of dislocation with a hip replacement?
Dislocation can happen at any time with a hip replacement, but the risk is higher in the first few days and the first 3 weeks after your operation.
This is because the tissues and muscles have not had enough time to heal and may not provide sufficient support to keep the prosthesis in place.
The causes of dislocation will differ depending on whether they occur between 0 and 3 months after the operation or 5 years or more after the operation (Lu 2019).
⚡If your dislocation is between 0 to 3 months could be due to a lack of mature scar tissue, insufficient tension of soft tissues or any health-related problems.
⚡Dislocations that occur after 5 years are mainly due to improper component positioning and polyethylene wear.
Fackler 1980:
▶️You have a higher risk of dislocating your replacement if.
⏏️Obesity of (BMI >30 vs <30 kg/m2) is associated with an increased risk of hip dislocation.
⏏️Your hip replacement has been revised at least two times.
⏏️You have had a hip dislocation before having a replacement.
⏏️If you have a history of osteonecrosis of the femoral head.
⏏️If you have had a femur head fracture before and you suffered from bone loss.
⏏️If you have neurological disorders, psychiatric diseases, and renal failure. These conditions are associated with increased hip dislocation risk.
And makes it worse if you are elderly because these health conditions weaken connective tissues (including ligaments, tendons, or muscles) around joints (Woolson.1999)
Findings from studies have been contradictory and plausible explanations have been proposed for these inconsistent findings. For example, it has been suggested that obesity is associated with limited mobility and hence less risk of complications such as dislocation. (Guo 2017; Woolson 1999)
This complication remains very rare, even when you have multiple risk factors. is uncommon, but it does occur sometimes in unforeseen circumstances.
▶️How do you fix a dislocated hip?
What does a slightly dislocated hip feel like?
Sometimes, you can feel like your hip has almost popped out of its usual spot, called the hip socket.
A partially dislocated hip’s symptoms include pain, but it might not be severe like a full dislocation, stiffness, and a limited range of motion.
You might also notice a weird feeling of your leg or a different look.
In some cases you might be able to walk and bear weight.
Treatment or reduction procedures.
If your hip has slightly moved out of joint and there are no other injuries. You will be given anaesthetic pain relief and an orthopaedic doctor will manipulate the bones back into their proper position. This is called a reduction.
However, if your hip has completely dislocated posterior or anterior, then you will be taken to theatre under anaesthesia to correctly help position the hip back in the joint.
In rare cases, torn soft tissues or small bony fragments block the femur from going back into the socket. When this occurs, surgery is required to remove the loose tissues and correctly position the bones.
Following reduction, post X-rays, and possibly a computed tomography (CT) scan will be requested to make sure the bones are in the proper position.
Non-surgical treatment
You will not go through surgery if the hip joint is successfully reduced and there is no associated fracture of the femoral head (ball) or acetabulum (socket).
In this case, you will likely not be able to put weight through your leg for 6 to 10 weeks.
Your doctor will advise you to avoid putting your injured leg in certain positions as you heal.
Surgical Treatment
Surgical treatment may be required if there are fractures associated with the dislocation, or if the hip is unstable even after reduction.
The goals of surgery are to restore hip joint stability and to restore the cartilage surfaces to their normal positions.
Typically, this requires a large incision, and the surgery may result in a lot of blood loss. Patients may require a blood transfusion during or after this surgery.
What happens if a dislocated hip goes untreated?
Treatment for a dislocated hip always includes emergency medical attention because it can cause permanent injury or even loss of the leg if the femur is not put back into the socket as quickly as possible.
▶️What is the recovery time for a dislocated hip?
Recovering from a dislocated hip reduction generally is much quicker than recovering from the initial hip replacement surgery because there is not reopening, and the tissues have not been torn.
for the hip to heal after a dislocation or replacement surgery may take 2 to 3 months. The rehabilitation time when to resume walking, driving and other activities may be longer if there are additional fractures. If all goes well the overall recovery time if a hip replacement, with or without a dislocation.
Your doctor may recommend limiting hip motion for several weeks to protect the hip from dislocating again.
How do you sleep with a dislocated hip
You must avoid bending your hip beyond 90 degrees while recovering from a dislocated hip.
Use a pillow between your legs and knees while sleeping to prevent the top leg from crossing over the bottom leg when you lie on your side.
you must not lie on your operated. Side for 12 weeks after your surgery. When sitting, don’t cross your legs.
You have reached the end of this article. I hope I have answered your main questions. I wish you a quick recovery.💁
📚Sources:
Guo L, Yang Y, An B, et al. Risk factors for dislocation after revision total hip arthroplasty: A systematic review and meta-analysis. Int J Surg. 2017; 38:123–9. [PubMed] [Google Scholar]
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Image: https://orthoinfo.aaos.org/en/diseases–conditions/hip-dislocation/