Surgical Dislocation of the Hip
What is Surgical Dislocation of the Hip?
Surgical hip dislocation is an orthopaedic surgical procedure in which the head of the thigh bone is displaced from the hip socket in the pelvic bone. It gives the surgeon a 360-degree view of the hip joint. Unlike accidental hip dislocation, which may be caused during a traumatic injury, your surgeon can perform the hip dislocation with minimal damage to surrounding healthy tissue.
Anatomy of the Hip
The hip joint is one of the body's largest weight-bearing joints and is the point where the femur, commonly known as the thighbone, and acetabulum or the hip socket, meets to form a ball-and-socket joint in which the head of the femur forms the ball and the pelvic acetabulum forms the socket. The joint surface is covered by smooth articular cartilage that cushions and enables smooth movement of the joint.
Indications for Surgical Hip Dislocation
Surgical hip dislocation may be performed to help treat the following conditions:
- Femoroacetabular impingement or FAI (excess bone growth on the joint surfaces)
- Slipped capital femoral epiphysis (growth plate at the top of the thigh bone slips out of place)
- Perthes disease (insufficient blood supply to the head of the thighbone)
- Complex hip deformities
- Tumours in the hip region
- Traumatic hip injuries
Preparation for Surgical Dislocation of the Hip
Specific instructions will be provided by your surgeon. In general, you should:
- Stop smoking as it can slow down the healing process.
- Inform your surgeon about any health conditions, allergies, and regular medications.
- Avoid eating 8-12 hours prior to the surgery.
Procedure for Surgical Dislocation of the Hip
- The surgery is usually performed under general anaesthesia.
- The incision is made along the side of the hip and extends to the top portion of the thigh bone.
- Your surgeon may separate and retract a portion of the bone from the greater trochanter which serves as the attachment site for several important muscles that help in the smooth functioning of the hip joint. By this method, your surgeon will be able to safely dislocate your hip without damaging the surrounding blood vessels and muscles ensuring continued blood supply to the region.
- The underlying subcutaneous tissue is carefully cut to gain access to the hip joint without injury to major muscles, tendons, ligaments, and cartilage.
- Dislocation is done by continuous traction of the knee as well as progressive flexion of the hip and external rotation of the thigh bone.
- For complete dislocation obstetric scissors are used to cut the ligamentum teres which stabilizes the hip while squatting.
- The lower leg with the knee in the flexed position is placed in a sterile bag. Controlled manipulation and a bone hook are used to safely dislocate the hip.
- Once the dislocation is complete, your surgeon is now able to fully identify and correct the abnormalities which are causing the hip disorder.
- The reduction of the dislocation is achieved by repositioning the bone hook and a controlled manoeuvre while the leg is gently pulled and internally rotated.
- The final reduction is done by hip extension.
- The separated bone fragments are held in place with screws and the incision is closed with sutures.
Post-procedure recovery after Surgical Dislocation of the Hip
- Patients who undergo surgical hip dislocation can expect to spend two or three nights in the hospital and to use crutches for a minimum of 4 to 6 weeks.
- During the hospitalization period, you will be instructed on various physical therapy exercises that help you recover your joint mobility and improve your muscle strength. You will be asked to stay away from physical activities that may strain your joints to avoid any mishaps during the recovery period.
- You will be monitored periodically during the first year after the surgery, to evaluate your hip and to ensure that the healing process is progressing well.
Risks and Complications of Surgical Dislocation of the Hip
Surgical dislocation of the hip is a very safe procedure; however, there is a minimal risk of bleeding, infection, delayed healing, and failure to heal after surgery.
Benefits of Surgical Dislocation of the Hip
Benefits of surgical dislocation of the hip include:
- Offers new insight into the cause of hip disorders
- Allows treatment of hip conditions that might not respond to hip arthroscopy
- May help improve outcomes of advanced hip preservation procedures