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Surgical Hip Dislocation

Surgical hip dislocation is a surgical procedure indicated for the treatment of specific hip disorders. With this procedure, the hip joint is accessed through an incision on the side of the hip. The greater trochanter is cut to allow access to the front of the hip capsule. The anterior hip capsule is cut to allow for dislocation of the femoral head and access to the hip joint. Dr. Duncan and his team can then surgically correct and treat problems in the hip with this wide exposure of the joint.

Why Would Surgical Hip Dislocation Be Performed?

Surgical Hip Dislocation can be used to surgically treat many problems of the hip, including:

  • Labral tears (damage to the labrum, which acts like a cartilage cuff around the hip socket)
  • Surface cartilage (articular cartilage) damage
  • Femoroacetabular impingement deformities
  • “Snapping hip” syndromes
  • Synovitis (inflammation of the joint)
  • Early arthritis
  • Ligamentum teres rupture
  • Loose bodies
  • Other uncommon conditions

How is the surgery performed?

Surgical hip dislocation is performed with the patient lying on their nonoperative side so that we can have access to the affected hip. An incision is made along the side of the hip. The greater trochanter is cut and flipped in front of the hip, allowing access to the hip capsule. The anterior (front of the hip) capsule is cut to allow for dislocation of the femoral head and wide access to both the femoral head and the acetabulum.

Depending on the reason for the surgery, different procedures may be performed. Flaps or frayed portions of the articular cartilage (early arthritis) can be shaved away or removed in a process called “debridement or chondroplasty.” Torn cartilage, labral tears, and synovitis can be successfully debrided. Acetabular labral tears can be repaired with “suture anchors.” These devices are anchored in the bone of the hip socket and the attached suture is used to refix the torn labrum. In cases of femoroacetabular impingement, abnormal bone protrusions can be removed with a burr. These bony protrusions may occur along the rim of the socket and/or on the femoral head/neck region. If the articular cartilage in the joint has been lost, small holes may be drilled into flat, bony areas of the hip. This procedure, “microfracture,” encourages the formation of new “repair cartilage” in the area of cartilage loss.

What Can I Expect from Surgical Hip Dislocation?

Every patient is unique, and the details of surgical dislocation procedures can vary. In general, surgical hip dislocation is performed under general anesthesia. You will be asleep during the procedure and you will not remember your surgery.

The length of the procedure largely depends upon the type of procedure being performed. Most procedures last three to four hours. Surgical hip dislocation is performed on an inpatient basis with a 1-2 day stay in in the hospital.

What Can I Expect in Recovery from Surgical Hip Dislocation?

After surgical hip dislocation, you will be on crutches for the first two to four weeks. You will be given oral pain medicines to manage the surgical discomfort. Physical therapy will start immediately after surgery with crutch training, gentle range-of-motion and active exercises. A CPM (continuous passive motion) machine will be used for one month to restore motion to the hip and help healing of the joint.

Dr. Duncan will outline a progressive physical therapy program for you to rebuild strength in the muscles around the hip joint. Most patients require 12 weeks of physical therapy to restore strength and mobility in the hip, but every patient is unique. In six weeks to two months, you should be able to resume most of your normal, everyday activities. However, it may take three to four months for the hip to fully recover from surgery. In many cases, the hip continues to improve for 12 to 18 months after surgery. Return to full sport activity is usually four months after the procedure.

Following surgical hip dislocation, it is very important to maintain your schedule of routine appointments with Dr. Duncan and his team so they he can monitor your progress after surgery.

Who is a Candidate for Surgical Hip Dislocation?

Surgical hip dislocation is generally performed on patients who are physically active, have hip pain, and a hip disorder that has not gone onto end-stage osteoarthritis that would otherwise be best treated with a total hip replacement.

What are the Risks and Benefits of Surgical Hip Dislocation?

All surgical procedures carry some risks. In general, surgical hip dislocation is safe and the major complication rate is low. Potential complications include but are not limited to infection, blood clots, nerve damage, femoral head avascular necrosis, bleeding, fracture, continued pain, heterotopic bone formation, scar tissue formation, instrument breakage, and anesthesia problems.

For those who are appropriate candidates for surgical hip dislocation, it may avoid or postpone the need to undergo total hip replacement. In some cases, surgical hip dislocation may fully address a hip problem with no need for further surgery.

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