In 90 percent of all cases of hip dislocation, the hip will dislocate backwards, or posterior, according to the American Academy of Orthopedic Surgeons, AAOS. This is a very serious and painful condition and often times requires severe trauma from a sport or an auto injury. The dislocated bone can cause damage to nerve or blood vessels near the joint causing loss of feeling further down the leg. Depending on how quickly the dislocation is resolved and how traumatic the dislocation is, will help determine what complications there will be further down the road.
Surgery
To reduce, or replace the dislocation, doctors will have to give a dose of sedative to help the muscle around the area relax so the bone can be pulled back into place. The AAOS states if there is more severe trauma or the doctor cannot move the leg with anesthesia alone, then the doctor may have to perform surgery and cut into the hip so the joint can be properly repositioned. If there has been severe damage or fractures to the joint, a partial joint replacement may be necessary before the dislocation can be fully reduced.
Rehabilitation
A dislocation usually includes a full or partial tearing or overstretching of the ligaments around the joint. Walking aids like crutches or a cane will need to be used to walk around until the hip pain diminishes and even after that, strengthening exercises will need to be done to prevent the likelihood of another dislocation. The AAOS states rehabilitation may take several months and may last even longer if the dislocation includes a hip fracture.
Osteoarthritis
A study published in "Journal of American Academy of Orthopedic Surgeons" in January of 2009 looked at the complications of reducing hip locations in children. This article stated that reduction of hip dislocation in children is not as common, but even with reductions in children, later life complications included osteoarthritis, a wearing down of the smooth surfaces of the hip joint.
Avascular Necrosis
Avascular necrosis is when the blood flow to the bone is cut off or damaged, according to the Mayo Clinic. This damage can happen from the initial trauma of the dislocation or even part of the process of reduction. A study published in "Internal Orthopedics" in August of 2006, stated if the reduction took more than one try, necrosis was a more likely complication than if the reduction only took one attempt.
Sciatic Nerve Injury
If reduction of the dislocation is not quickly addressed, there is a chance the sciatic nerve, the largest nerve in the body which courses from the low back down the buttocks and into the leg, will be compressed. The length of time the sciatic nerve is compressed upon will determine how much damage there may be to the nerve and how long it will take to recover. The same article mentioned above, published in "Internal Orthopedics" in August of 2006 stated the cumulative average of sciatic nerve injury is around 10 percent of those with a dislocation. Most people heal from these injuries within a few months, but in cases where the reduction took longer than 12 hours, complete recovery had not been achieved even after two years post injury.
References
- American Academy of Orthopedic Surgeons: Hip Dislocation
- "Internal Orthopedics;" Complications after posterior dislocation of the hip.; AJ Dwyer, et. al.; August 2006.
- "Journal of American Academy of Orthopedic Surgeons;" Traumatic Hip Dislocations in Children and Adolescents: Pitfalls and Complications.; José A. Herrera-Soto, MD and Charles T. Price, MD; January 2009.
- Mayo Clinic: Avascular Necrosis
