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Hip dislocation

Find out what causes a hip dislocation and how it can be treated

The hip is described as a ‘ball and socket’ joint and is formed by the upper part of the thigh bone (the femur) sitting inside the socket-like part of the pelvis, which is known as the acetabulum.  

Owing to the fact that the joint is formed with a very deep and congruent socket, a normal hip joint is extremely strong and stable. Although this structure gives the hip joint a good amount of mobility, it does mean that it is also susceptible to injury.  

Hip dislocation occurs when the top of the femur is forced out of the socket in your pelvis. This can cause severe pain and lack of mobility. 

A hip dislocation is not very common. This is mainly because the structure of the hip joint means that the head (top) of the femur sits deeply within the socket and is very hard to dislodge. By way of comparison, dislocation of the shoulder joint is much more common as the top of the arm bone (humeral head) sits less deeply in the joint.

Hip dislocations are split into two categories based on the location of the head of the thigh bone:

Posterior hip dislocation: This is the most common type of the condition. Posterior dislocation is characterised by the knee and the foot pointing in towards the middle of the body. In cases, the sciatic nerve will also be injured.

Anterior hip dislocation: This type of dislocation is less common and is characterised by external rotation of the knee and foot away from the body. In extremely rare cases anterior dislocation can cause nerve injury.

In the majority of cases, a hip dislocation is the result of significant trauma or injury, such as:

  • Road traffic accident (RTA).
  • Fall from a height (for example, a fall off a ladder).
  • Impact during a sports game (for example, a rugby tackle).

A hip replacement dislocation can also occasionally occur following total hip replacement surgery, although again this is not very common. If you have had hip replacement surgery then you may experience partially dislocated hip symptoms as an indication that there are problems with your hip.

Congenital hip dislocation is found in infants and is a condition where the ball and socket joint of the hip has not properly formed. Congenital dislocation is sometimes called developmental dysplasia of the hip (DDH) or hip dysplasia.

Symptoms that you may experience following a hip dislocation can be divided into two categories, primary and secondary.

Primary symptoms

Pain: The most common symptom of a hip dislocation is painful and you will feel severe hip pain.

Unable to move: You will find it extremely difficult to move without exacerbating the pain and will almost certainly be unable to weight bear. Walking with a dislocated hip is very difficult.

Shortened and rotated leg: A ‘classic’ sign of hip dislocation is for the leg in the affected side to be shortened and rotated outwards. This occurs when the thigh bone ‘pops’ out of the socket; when the strong leg muscles then contract, the thigh bone is pulled higher up the body than normal.

Secondary symptoms

The force required to cause hip dislocation means that there is often also significant damage to the areas surrounding the hip. These can include:

  • Fracture(s) in the pelvis.
  • Tears/damage to the cartilage and ligaments of the hip.
  • Injury to the blood vessels that nourish the bone: if the blood supply to the bones in the hip is cut off, death of bone tissue (avascular necrosis) can occur.

How a dislocated hip is treated will be depend on whether it is the result of a major trauma or due to the failure of a hip replacement. Dislocated artificial hip treatment is the same the treatment for traumatic hip dislocation.

A hip dislocation is classified as a medical emergency, meaning your immediate treatment will probably be through an Accident and Emergency department at the hospital.

Surgery: The main objective for treatment is to reposition the top of the thigh bone (femoral head) into the acetabulum correctly.

There are two methods for achieving this, the first is a closed reduction, in which the leg is forced back into place without the need for cutting into the leg. The second is an open reduction, in which incisions are made into the hip.

Both of these will usually be done under general anaesthesia due to the force required to move the bones back into their correct position. Leading up to the operation (known as a joint reduction), you will be given pain medication to reduce the pain as much as possible.

Treatment following surgery: Once your hip dislocation has been restored by surgery, the work begins to help you recover as quickly, fully and safely as possible.

It will take time to build up your leg muscles again and to be able to mobilise safely. Our team of physical therapists will help you with a course of exercises to build strength in your muscles and improve your mobility.

If you’ve experienced a hip dislocation and are struggling with recovery, mobility or ongoing pain in the hip, you can discuss your symptoms with one of our hip consultants. In addition, the last thing that you want is to have to wait for your treatment.

Our orthopaedic surgeons will be able to use their vast experience to advise you on the best course of action and/or therapy to have you moving confidently again, without pain in the long term.

Alongside our orthopaedic surgeons, we have a multidisciplinary team of healthcare professionals who will help you as you recover.

Our physiotherapists have access to state-of-the-art technologies and equipment as well as mobility aids such as crutches and walking frames. They will work with you to help you throughout your recovery and to ensure you are able to move safely and confidently once again as soon as is medically possible.


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