Facts you should know about hip dislocations
A hip dislocation happens when the head of the femur is forced out of its socket in the pelvis.
- Hip dislocations occur most often as a
result of motor vehicle crashes. They also can be an athletic injury, most
commonly from football or downhill skiing trauma.
- The hip can dislocate forward or
backward (anteriorly or posteriorly). Posterior dislocation of the hip is most
- It is important to try to relocate
(reduce) the dislocated hip joint as soon as possible to prevent complications.
- Doctors usually accomplish reduction of the dislocated hip with
traction, but an operation may be required if that is unsuccessful.
- A person may need physical therapy and rehabilitation for many months to regain normal function.
- Complications of hip dislocations
include damage to the sciatic nerve, osteoarthritis, and death of the femur bone
of the hip (avascular necrosis of the femoral head).
Hip Dislocation Symptom
Symptoms associated with hip pain depend on the cause. Symptoms include
- joint pain,
- groin pain,
- loss of motion of the hip,
- swelling over the hip,
- tenderness of the hip,
- difficulty sleeping on the hip.
What is a hip dislocation? What are the types of hip dislocations?
The hip is a ball and socket joint. The ball is the head of the femur or
thighbone and the socket in the pelvis is called the acetabulum. Surrounding muscles and ligaments and a thick band of
cartilage called the labrum stabilize the joint. A hip dislocation occurs when the femoral head is
forcibly removed from the acetabulum.
Doctors describe hip dislocations according to where the femoral hip bone moves
in relationship to the acetabulum.
- Posterior dislocations, where the
femoral head moves backward, are most common and often occur from car wrecks
and athletic injuries.
- Anterior hip dislocations occur when the
femoral head pushes forward out of the socket of the acetabulum. This type of
hip dislocation can occur in downhill skiing accidents.
- Patients who have had hip replacements
can also dislocate their prosthetic hip.
- Developmental dysplasia of the hip
(dys=bad + plasia=formation) is an abnormal design of the hip at birth (was formerly
referred to as congenital hip dysplasia). Developmental dysplasia can lead to hip
dislocation in infants and children.
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What causes a dislocated hip?
Hip dislocations are an uncommon injury in a normal hip. It takes a lot of
energy to dislocate a hip, and most dislocations of the hip are due to motor
vehicle injuries. Athletic injuries most often occur in football and rugby,
downhill skiing, and snowboarding.
In patients who have had hip replacements, a simple fall or abnormal movement
may provide enough energy to dislocate the hip prosthesis.
What are risk factors for hip dislocations?
The risk of a hip dislocation exists with any high-impact, high-energy
accident. Hip dislocations occur most commonly in motor vehicle crashes,
pedestrians hit by cars and, less commonly, athletic injuries.
What are signs and symptoms of hip dislocations?
Pain, deformity, muscle spasm, and inability to move the hip are common
symptoms and signs of hip dislocation. The patient will not be able to bear weight or
stand on the hip.
On physical examination, the hip and leg will be in an abnormal position
and there will be physical deformity.
- For posterior hip dislocations, the hip
will be short and internally rotated, meaning that the foot will be pointing
inward toward the midline of the body.
- Anterior hip dislocations will have a
shortened leg with the foot externally rotated or pointing away from the midline
of the body.
How do doctors diagnose a dislocated hip?
Physical examination often clinically diagnoses hip dislocations. The
health care provider might be able to observe a deformity at the hip, as well as
abnormal positioning of the hip. X-rays confirm the diagnosis of hip
The health care provider will also look for complications associated with hip
dislocation, including injury to the femoral artery that runs in front of the
joint and the sciatic nerve located in the back of the hip.
Depending upon the situation, the health care provider may assess the patient
for other injuries that might be present.
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What is the treatment for a hip dislocation?
The initial treatment of a dislocated hip is to try to relocate it, replacing the
femoral head into the hip socket. Because of pain and muscle spasm associated
with the injury, the patient often requires medications for sedation and muscle
relaxation to allow the hip to be relocated. There are different techniques that
can be used to relocate the hip, but all involve traction on the leg to replace
the femoral head back into the acetabulum. This is called closed reduction.
Sometimes the hip cannot be relocated, even with the patient undergoing
general anesthesia. A CT scan may be needed to look for small bone fragments
that may have fractured (broken off) off the acetabulum or pieces of torn
ligament or cartilage that get in the way of the relocation. In this situation,
open reduction is required, meaning that an orthopedic surgeon has to operate to
remove any foreign objects in the joint and then reduce or replace the hip back
into its socket. Sometimes doctors do this using arthroscopic surgery.
After hip reduction, physical therapy and rehabilitation will be
required to return range of motion and regain strength in the muscles
surrounding the hip.
Medically speaking, the term "myalgia" refers to what type of pain?
What are complications of a dislocated hip?
Common complications include the following:
- Sciatic nerve injury: The nerve runs
behind the hip and can be stretched and damaged with a hip dislocation.
- Avascular necrosis of the femoral head
(a=loss + vascular=blood supply; necrosis=death): The femoral head, or ball of
the hip, gets its blood supply from small arteries that run along the ligaments
that help hold the hip joint stable. These arteries can be stretched, damaged, or
torn with a hip dislocation and the part of the bone that they supply can die
(necrosis). This causes the hip joint to gradually lose its range of motion and
potentially require hip joint replacement. For this reason, the goal is to
reduce a dislocated hip as soon as possible. A follow-up MRI of the hip is usually recommended at 6 weeks to look for this
- Osteoarthritis of the hip joint
- Recurrent hip dislocation: The
structures that keep the hip stable may not heal adequately, leading to repeated
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What is the recovery time for a hip dislocation?
Physical therapy is important and begins with non-weight-bearing exercises
that can start after the first week. This is important to prevent loss of range
Strengthening of leg muscles can begin when the patient is pain free and can
walk without crutches, usually after 4-8 weeks.
If all goes well, it may take 3-4 months to return to full activity after a
What is the prognosis for a dislocated hip?
Hip dislocations are a significant injury and the prognosis depends upon how
long it takes to reduce the dislocation and whether other structures are
About 70% of patients with posterior hip dislocations will have an associated
Approximately 10%-15% of patients with hip dislocation will have sciatic nerve injury.
About 2%-10% of patients with a hip dislocation will develop avascular necrosis of
the femoral head if it is reduced within 6 hours.
Approximately 20% of patients with hip dislocation will eventually develop osteoarthritis
in the hip joint.
Is it possible to prevent hip dislocation?
Hip dislocations occur because of unexpected events and cannot be prevented.
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Medically Reviewed on 11/21/2019
Dawson-Amoah, K., J. Raszewski, N. Duplantier, and B.S. Waddell. "Dislocation of the
Hip: A Review of Types, Causes, and Treatment." Ochsner J 18.3 (2018): 242–252.