Post-Hip Dislocation

Because the hip joint is a ball-and-socket joint with massive ligaments, it is a very stable joint. It is therefore injured less frequently. However, athletes are getting bigger and stronger as the years go by, therefore the amount of forces on the athletes are tremendously high and increasing every year. The most common hip dislocations occur posteriorly because of the greater strength of the anterior capsule of the joint. They are also more common because in sports such as football, rugby, hurling, and soccer, the individual is hit in the front of the thigh, forcing the thigh/hip complex backward, resulting in hip dislocations. This tears the ligamentum teres and the posterior capsule.

The vascular supply to the femoral head is stretched and torn as the posterior displacement increases. Once the hip is surgically reset (put back in place), the athlete must use crutches for two weeks after the injury. Protected weight-bearing is continued for two to six months, depending on the surgeon's school of thought. (Henry, J. Traumatic injuries to the hip. In The Hughston Clinic Sports Medicine Book, published by Williams & Wilkins, Philadelphia, PA, 1995, pp. 392-402.)

Generally, the athlete is not allowed to return to athletics for a minimum of three months. Long-term consequences of posterior hip dislocations can include sciatic nerve injury, avascular necrosis of the femoral head (hip joint damage due to decreased blood supply), and significant arthritis and cartilage damage.

A joint dislocation significantly disrupts all the structures that support the joint. The athlete will be out of commission for a minimum of three months if he/she does traditional sports medicine treatments. Even after all of that time, there is no guarantee that you will be left with a strong hip joint. If strengthening the hip has not been accomplished, then the athlete is on the way to sustaining another dislocated joint in the future. For most athletes who choose the traditional route of treatment for joint dislocations, you will be looking at three to six months of abstinence from your sport, followed by months of rehabilitation and babying of the joint. There must be a better way.

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