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Hip

How to Treat Posterior Hip Dislocations

Introduction Hip dislocations are uncommonly encountered in athletes but they do occur.

J
John Kiel
Sports Medicine Physician ยท September 26, 2022 ยท 3 min read

Overview

Hip dislocations are uncommonly encountered in athletes but they do occur. Famous examples include American football players Tua Tagovailoa and Bo Jackson. Other sports with case reports of dislocations include skiing, snowboarding, rugby and basketball. More than 90% of dislocations are posterior. There are two mechanisms that can produce a posterior dislocation: a forward fall on a flexed, adducted knee producing a posterior force or a blow from posterior to anterior while the athlete is on their hands or knees.

Causes and Risk Factors

Pelvic radiograph of posterior hip dislocation. Pelvic radiograph of posterior hip dislocation. In a posterior hip dislocation, the athletes leg will be adducted, internally rotated and shortened.

Treatment Options

It is not possible to tell if there is a fracture vs dislocation or both, although a careful examination help direct an index of suspicion. In most cases, the patient will be transported to the hospital where radiographs should be obtained prior to reduction. Because of the large muscle groups around the joint, reduction typically requires procedural sedation to relax the musculature.

Recovery

There are multiple reduction techniques which will be reviewed. Time to reduction is critical as hip dislocations are associated with a high rate of avascular necrosis which directly correlates with duration of dislocation. Depending on associated injuries, AVN risk is as high as 50% and 25% of dislocations will go on to develop osteoarthritis.[ref]Dwyer AJ, John B, Singh SA, Mam MK.

When to See a Doctor

If you are experiencing symptoms that may be related to management of posterior hip dislocations, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

Hip
J
John Kiel
Sports Medicine Physician
Sports Medicine Review contributor

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