Hip Dislocation

What is hip dislocation?

Hip dislocation is a painful event in which the ball joint of your hip comes out of its socket. It usually occurs from a significant traumatic injury. (Artificial hip replacements are somewhat easier to dislocate.)

A dislocated hip is a medical emergency. It causes acute pain and disables your leg until it’s corrected. It can also cause secondary injuries to the surrounding blood vessels, nerves, ligaments and tissues. Hip dislocation can cause long-term damage, especially if it’s not treated right away.

Hip dislocation can sometimes occur as a result of hip dysplasia, a developmental condition in which your hip joint doesn’t fit well in the socket. Hip dysplasia is also called “developmental dislocation of the hip” (DDH). People with hip dysplasia have shallow hip sockets, which don’t hold their joint in place as well as normal hips do. They may also have loose muscles and ligaments in their hip, so it takes less force to displace their joint than it would for most of us.

What is a partial dislocation of the hip (subluxation)?

A partial dislocation is known medically as a subluxation. It means that your ball joint has shifted partially out of its socket, but not all the way out. A subluxation can be mild or severe. It’s common in people with hip dysplasia and hip replacement.

Severe subluxation tends to be caused by injury. More severe cases may be nearly as painful and debilitating as a total dislocation, and may also need to be reset by a healthcare professional. Listen to your body and seek professional help if you’re in severe pain or unable to walk.

A milder case may be caused by general wear and tear on your hip, when the cartilage that helps seal your joint in its socket has eroded. It may be chronic or recurring. If you have a mild subluxation, you might still be able to walk, and you might be able to pop it back into place yourself with gentle stretching.

Does my hip pain mean that my hip is dislocated?

The hip is normally one of the most secure joints in your body. Unless you have a prosthetic hip or hip dysplasia, it takes a lot to dislocate a hip joint. A dislocated hip is acutely painful and disabling and usually follows a significant injury. However, if you’ve had a minor injury, or if your hip has suffered a lot of wear and tear, you may have a subluxation. Notice if you feel your hip snapping in the socket when it moves, or if it’s hard to bear weight on your leg. Your healthcare provider can help you identify the cause of your hip pain and recommend the right therapy.

What causes hip dislocation?

Hip dislocation is usually caused by a traumatic injury. It normally takes a lot of force to push your hip joint out of its socket. A car crash is the most common cause. It can also be caused by a significant fall or a sports or industrial workplace injury.

If you or your child have developmental dislocation of your hip (hip dysplasia,) it might take much less force to dislocate your joint. People who have had a hip replacement are also more at risk of dislocation from ordinary activities.

What does a dislocated hip look like?

If you’re looking at the injury from the outside, you’ll first notice that your leg is locked in a fixed position, rotated either inward or outward. About 90% of the time, your hip joint is forced backward out of its socket (posterior dislocation), which leaves your knee and foot pointed inward. When your hip is pushed forward out of its socket (anterior dislocation), your knee and foot will point outward. Your rotated leg may also appear shorter or longer than the other. You may be able to see that your hip isn’t aligned, or you may see swelling or discoloration at your hip.

What are the symptoms of hip dislocation?

• Acute pain.
• Muscle spasms.
• Swelling or discoloration at your hip joint.
• Leg is rotated inward or outward.
• Inability to move your leg.
• Inability to bear weight on your leg.
• Loss of feeling in your hip or foot.
• Hip is visibly out of place.

What are the potential complications of hip dislocation?

A dislocated hip joint can damage the nearby nerves, blood vessels and tissues, which may need to be repaired separately. Sometimes, this damage can have long-term consequences, including:

• Nerve damage. Your dislocated joint can impact your sciatic nerve, which runs from your lower back through your hip and down your leg, branching into your foot and toes. Compression of your nerve causes chronic pain, commonly known as sciatica. Damage to your sciatic nerve can impair your ability to flex your foot and toes.
• Osteonecrosis. If the femoral artery that runs in front of your joint is damaged, it can affect the delivery of blood to your bone. When blood is cut off, your bone tissue begins to die, and tiny fractures begin forming, destroying the structural integrity of your bone. This is called osteonecrosis or avascular necrosis.
• Arthritis. Hip dislocation can damage the cartilage that cushions your ball joint in its socket, as well as the ring of cartilage surrounding your joint, called the labrum. This often leads to arthritis and increases the likelihood of needing a hip replacement later in life.

How is a dislocated hip diagnosed?

A trained healthcare provider can often identify a dislocated hip by looking at it. But they’ll also want to perform a full physical evaluation to check for other related injuries. They may order imaging tests, such as X-rays or a CT scan, to better see the position of your bones and screen for any fractures before attempting to correct them.

How is a dislocated hip treated?

• Urgent care: If you suspect you have a dislocated hip, don’t try to move it. Call an ambulance and go to the emergency room. The injury is acutely painful and must be treated urgently to minimize long-term damage. Correcting your hip requires training, medication and assistance, and it’s only safe to perform after other related injuries have been identified. Secondary injuries may require surgical intervention, as well. Correction is most successful when performed within a few hours of the injury.
• Hip reduction: To correct your dislocated hip, your healthcare provider will physically move your joint back into place. This is called a reduction. When there aren’t any secondary injuries, the correction can be done externally (“closed reduction”). It takes a lot of force to dislocate a hip joint, and a lot of force to put it back. Your healthcare provider will recommend some combination of anesthetic and sedatives to reduce pain and muscle spasms during the procedure. Sometimes, it’s done under general anesthesia.
• Surgery: If there are significant secondary injuries, the reduction may need to be done in the operating room, where nerves and blood vessels can also be treated. Surgery is also the treatment of choice for infants who’ve suffered hip dislocation, especially as a result of hip dysplasia. In surgery, the joint can be stabilized to prevent future dislocation. This has a 90% success rate with infants.

If you’ve had a hip replacement

Surgery may also be recommended when your displaced hip is an artificial hip replacement. The implant may need to be replaced again, or reinforced.

How can I prevent hip dislocation?

• Safety: Since hip dislocation usually results from an accident, common safety guidelines are the best prevention. Always wear your seatbelt in the car and wear protective gear when participating in contact sports. Take precautions when using a ladder or workplace equipment, too.
• Conditioning: If you’ve previously dislocated your hip, it might be more prone to dislocating again. You can help reinforce your joint by strengthening your hip tendons and muscles through physical therapy and keeping them conditioned through regular exercise.
• Hip dysplasia care: Children with hip dysplasia should be treated while their skeletons are still growing to prevent future injury.

Hip implant care

Follow the safety guidelines given to you by your healthcare provider when you received your hip replacement. Hold on to the rail when using stairs, and take it slowly when bending at your waist.

How long does it take to recover from a dislocated hip?

After your joint has been reduced, it can still take two to three months for your hip to fully heal. Your healthcare provider may recommend limiting hip movement for the first few weeks, and physical therapy after that. You might need crutches to walk for the first week or two, too.

If you’ve had a hip replacement

If you’ve had a replacement hip, your healthcare provider might recommend a brace to stabilize it while it heals.

What is the outlook for a hip that has been dislocated?

Time-sensitive treatment is more likely to result in a full recovery. When a hip is dislocated by a high-force trauma, secondary injuries are common. The risk of long-term complications from injured nerves and blood vessels increases if they aren’t treated within hours.

All hip dislocations weaken your muscles and ligaments that hold your hip joint in place and erode the cartilage that cushions your joint in its socket. The longer your injury goes untreated, the more your joint will be destabilized. This can increase the likelihood of future dislocation injuries. It’ll also cause arthritis in your joint to develop over time in about 50% of cases. Arthritis may lead to an eventual hip replacement, which is again more likely to dislocate. You may recover well in the short term, but the injury may come back to haunt you later in life.

If you’ve had a hip replacement

When an artificial hip is dislocated, it may not have suffered the kind of force that would cause secondary injuries. But these dislocations are at risk of another time-sensitive outcome — muscles contracting away from the implant and no longer holding it in place.

A note from Cleveland Clinic:

Don’t mess around with a dislocated hip. It’s a medical emergency, and both short-term relief and long-term recovery depend on urgent care. Your dislocated hip was most likely caused by a traumatic injury. If so, there are likely other injuries involved, such as fractures and tears. But if you have a replacement hip, it may have dislocated more easily, from something as simple as sitting on a low chair or crossing your legs. You may not have secondary injuries, but correcting the dislocated hip is just as urgent to relieve pain and restore its functionality. Quality medical care will help you preserve as much of your hip functionality as possible, for as long as possible. Don't hesitate to seek emergency care if you suspect a dislocated hip.