How Are Hip Dislocations Treated After a Fall?

To treat hip dislocations after a fall, our hip surgeon, Dr. Charles Ruotolo, first performs a thorough evaluation using X-rays and other imaging to confirm the dislocation. After that, he may perform a closed reduction to carefully move the hip back into its original position. However, if the fall causes fractures, cartilage damage, or joint instability, he may recommend surgical repair.

After your treatment, our team at Total Orthopedics & Sports Medicine closely monitors your healing and develops a recovery plan to restore hip strength and mobility. We also assess your range of motion and identify factors that may increase the risk of another dislocation. Call us today at 855-321-6784 to schedule your appointment with Dr. Charles Ruotolo in Massapequa.

What Is the Best Treatment for Hip Dislocation?

Closed reduction, open reduction surgery, and fracture fixation are considered the most effective hip dislocation treatments. In some cases, our fellowship-trained hip surgeon may also recommend arthroscopy or hip replacement surgery to restore your hip joint function. Here’s how these treatments can help relieve pain, restore hip stability, and improve mobility after a hip dislocation:

Closed Reduction

A closed reduction is the gold-standard first-line treatment for most hip dislocations. During this procedure, your surgeon carefully moves the femoral head back into the hip socket while you are under sedation or anesthesia. Once the hip is back in its proper position, hip pain often improves, and pressure on nearby nerves, blood vessels, and soft tissues decreases. After the procedure, you should follow a structured recovery plan that may include temporary activity restrictions, bracing, and rehabilitation to help stabilize the joint and support proper healing.

Moreover, this orthopedic procedure restores normal joint alignment and decreases the risk of long-term complications, including:

• Avascular necrosis (osteonecrosis) caused by disrupted blood flow to the femoral head
• Permanent cartilage damage within the hip joint
• Chronic hip pain that persists after a serious injury
• Recurrent hip dislocations due to ongoing joint instability
• Reduced hip mobility and stiffness that limit daily activities
• Post-traumatic arthritis resulting from damage to the joint surfaces
• Nerve injuries that cause weakness or numbness in the leg

In fact, according to a case study published on NCBI, a 45-year-old man with Parkinsonism and cognitive deficits underwent a primary total hip arthroplasty (THA). Within two weeks of surgery, he experienced a posterior hip dislocation after standing from a low chair. Over the next two months, he sustained three additional dislocations, all of which were successfully treated with closed reduction under sedation.

Open Reduction Surgery

Open reduction surgery is necessary if a closed reduction cannot safely return the hip to its proper position. In this surgery, the hip specialist makes an incision to directly access the hip joint and remove any bone fragments or damaged tissue that are blocking proper alignment. By addressing these issues directly, the orthopedic surgeon can restore proper joint alignment more accurately. In addition, this surgical approach helps the doctor identify cartilage injuries and ligament damage resulting from the dislocation. Treating these injuries during the procedure can help improve hip stability and function.

Fracture Fixation

Fracture fixation is often recommended when a hip dislocation occurs alongside a fracture of the pelvis, acetabulum, or femur. During this procedure, doctors use specialized screws, plates, or other fixation devices to hold the broken bone fragments in their original position. These devices also help stabilize the hip joint and maintain proper alignment during the healing process. Other than that, this treatment can reduce pain, decrease swelling, and support a successful recovery.

Hip Arthroscopy

Arthroscopy is often recommended when a hip dislocation causes cartilage injuries, loose bone fragments, or persistent hip symptoms. In this surgery, the doctor uses a small camera and specialized instruments to examine damage inside the hip joint through tiny incisions. After that, they repair damaged cartilage, remove loose fragments, and address other related injuries affecting joint function. Treating these injuries helps restore smoother movement within the hip joint. Correcting the underlying damage can also reduce pain, stiffness, and mechanical symptoms such as:

• Catching sensations during movement
• Hip locking or restricted motion
• Clicking or popping in the joint
• Pain during walking or daily activities
• Reduced hip flexibility and range of motion

Hip Replacement Surgery

If a traumatic hip dislocation causes severe joint damage that cannot be effectively repaired, your doctor may recommend total hip replacement surgery. During this surgical intervention, the damaged portions of the hip joint are removed and replaced with the following artificial components to restore smooth movement:

• Acetabular Component: A metal shell that replaces the ball and socket portion of the joint and creates a stable foundation for the new joint.
• Liner: A durable plastic, ceramic, or metal insert placed inside the acetabular component to reduce friction during movement.
• Femoral Stem: A metal implant inserted into the femur to provide structural support and anchor the artificial joint.
• Femoral Head: A metal or ceramic ball attached to the femoral stem that replaces the damaged ball-shaped top of the thigh bone.

Moreover, a Cureus study evaluating total hip arthroplasty for congenital hip dislocation (CHD) found that this procedure significantly improved pain, mobility, and overall hip function. This study included 16 patients (19 hips), and 75% of cases involved high hip dislocations. Before orthopedic surgery, most patients had significant limping and leg-length discrepancies averaging 39 mm. After THA, the average Postel and Merle d’Aubigné (PMA) score improved from 8.41/18 to 17.23/18.

Note: A hip dislocation is a medical emergency and should be treated within 6 hours to reduce the risk of permanent joint damage and avascular necrosis (bone death).

What Are the Symptoms of a Dislocated Hip?

If you experience severe hip pain, difficulty moving your leg, and an inability to bear weight after an injury, you may have a dislocated hip. You may also notice a visible deformity around the hip, a leg that appears shorter than the other, or a foot that points inward or outward abnormally. Besides that, many patients experience immediate swelling, bruising, and significant stiffness that limit hip movement.

Moreover, if nearby nerves are affected, numbness, tingling, or weakness in the leg may also develop. These warning signs often may indicate a complete dislocation, requiring prompt treatment to prevent further damage, such as:

• Labral tears: Traumatic injury to the cartilage ring surrounding the hip socket, leading to pain and instability.
• Articular cartilage damage: Degeneration of the cartilage covering the joint surfaces, which can affect smooth hip movement.
• Ligament and soft tissue tears: Damage to the hip structures that help keep the hip joint in place.
• Post-traumatic hip instability: Ongoing looseness of the joint that increases the risk of future dislocations.
• Post-traumatic arthritis: Joint wear and tear that can cause chronic pain, stiffness, and reduced mobility after a hip dislocation.

For example, according to a NIH meta-analysis of hip dislocations, post-traumatic arthritis (PTA) is one of the most common long-term complications following a hip dislocation. This review found that the rate of post-traumatic arthritis ranged from 12.5% to 70% in anterior hip dislocations and from 19.4% to 58.6% in posterior hip dislocations. Researchers also found that more severe dislocations have a higher risk of arthritis.

Is Avascular Necrosis Common After Hip Injury?

Yes, avascular necrosis (AVN) is a relatively common complication after a traumatic hip injury, especially when a hip dislocation is not treated promptly. AVN develops when the blood supply to the femoral head is disrupted, causing bone tissue to die over time. In fact, according to a PubMed analysis of traumatic hip dislocations, the rate of AVN ranged from 8.7% to 33.3% in anterior hip dislocations and from 10.6% to 43.0% in posterior hip dislocations. The study also found that delayed treatment significantly increases the risk.

To reduce the risk of avascular necrosis (AVN) after a hip dislocation, our hip surgeon, Dr. Charles Ruotolo, immediately evaluates your painful injury and performs prompt hip reduction. This immediate treatment improves blood flow to the femoral head, supporting bone survival and reducing the risk of AVN. Moreover, if you’re unsure whether the recommended treatment is the best option for your condition, Dr. Charles Ruotolo also offers second-opinion consultations.

During your visit, he carefully reviews your medical records and previous treatment recommendations to provide an independent assessment of your hip injury. He will also explain all available treatment options and analyze if your current treatment plan aligns with your recovery goals. This evaluation helps you make informed decisions about your treatment. Call 855-321-6784 to schedule your appointment.

What’s the Difference Between a Hip Dislocation & a Fracture?

A hip dislocation occurs when the femoral head (the ball of the hip joint) is out of the hip socket. On the other hand, a hip fracture is a broken bone of the femur or pelvis, while the hip joint itself may still remain in its normal position. Beyond that, a hip dislocation may cause joint instability, cartilage damage, labral tears, and disruption of blood flow to the femoral head.

In contrast, hip fracture symptoms include severe pain, difficulty standing or walking, and significant tenderness around the injured area. It may also lead to loss of bone strength around the injury site, increasing the risk of delayed healing. However, in some cases, both injuries can occur together, especially after high-impact trauma, such as:

• Car accidents
• Motorcycle accidents
• Falls from significant heights
• Crush injuries
• Industrial workplace accidents
• Construction site falls
• Sports-related collisions
• Heavy object impacts

How Do Orthopedic Specialists Confirm a Dislocated Hip?

To diagnose a hip dislocation, our surgeon, Dr. Charles Ruotolo, begins with a detailed physical examination to assess pain level, leg position, and range of motion after injury. Then he may order imaging tests, such as X-rays, to confirm whether the femoral head has moved out of the hip socket. This imaging tool also helps determine the direction and severity of the dislocation, which is important for planning treatment.

In some cases, Dr. Charles Ruotolo may use MRI scans to evaluate damage that may not be visible on X-rays. This advanced imaging provides a more detailed view of the hip joint and surrounding soft tissues. In fact, according to an NIH study, researchers conducted MRI scans on 18 patients within 5 weeks of a hip dislocation. After the analysis, they found that all patients had joint effusion or bleeding.

Among patients with posterior dislocations, MRI also identified femoral head contusions, small fractures, and osteochondral defects. After conducting imaging studies and a physical evaluation, our AAOS member, Dr. Charles Ruotolo, may also ask the following questions to confirm the diagnosis:

• How did the injury occur?
• When did your symptoms begin?
• Are you able to stand or bear weight on the affected leg?
• Did you hear or feel a pop at the time of the injury?
• Where is your pain located, and how severe is it?
• Have you noticed any numbness, tingling, or weakness in your leg or foot?
• Did your hip appear out of place immediately after the injury?
• Have you had a prior hip dislocation or injury?
• Have your symptoms improved, worsened, or remained the same since the injury?
• Do certain movements increase your pain or discomfort?

What Should You Do Immediately After a Hip Dislocation?

If you suspect a hip dislocation, call 911 or go to the nearest emergency room immediately, and avoid moving the affected leg. A hip dislocation is a medical emergency that can disrupt blood flow to the hip joint and damage nearby nerves, cartilage, and soft tissues. While waiting for medical care, keep the injured leg as still as possible and avoid straightening, rotating, or repositioning it.

You should also avoid standing, walking, or putting weight on the affected leg, as these movements can worsen the injury. If available, apply ice wrapped in a cloth to help reduce pain and swelling. Here are some additional steps you should take immediately after a hip injury:

• Remove tight clothing or accessories around the hip/leg if it can be done without moving the joint
• Note the time of injury to help guide urgent treatment decisions
• Check for other injuries from the fall, such as head, spine, or pelvic trauma
• Avoid taking pain medication without medical advice

How Long Does It Take to Recover from a Dislocated Hip?

After a hip dislocation, recovery typically takes 2-3 months for early healing, but full recovery can take 3 to 4 months or longer, depending on the severity of the injury. In the first 1–2 weeks, you may need crutches and braces to improve mobility. After weeks 3–6, you can often begin gradual, controlled movement as the hip stabilizes and swelling decreases.

Between 6 and 12 weeks, strength and basic mobility begin to improve, and you can begin partial weight-bearing on the affected hip. But at this stage, you should still avoid running, jumping, and sudden twisting movements that place excessive stress on the healing joint.

From 3–6 months, you can return to most daily activities with improved hip strength, balance, and overall joint function. You can also gradually resume low-impact exercises and recreational activities as your hip heals and regains stability. However, the long-term recovery depends on several factors, including:

• Time to treatment: Prompt reduction often leads to a faster recovery and fewer complications.
• Cartilage damage: Injuries to the joint cartilage may delay recovery and affect long-term function.
• Treatment method: Surgical treatment typically requires a longer recovery than a closed reduction.
• Age and overall health: Younger, healthier patients often heal more quickly.
• Development of complications: Conditions such as avascular necrosis or post-traumatic arthritis can delay recovery.

Which Exercises Help Strengthen the Hip After Recovery?

Straight leg raises, glute bridges, clamshells, and standing hip abductions can strengthen your hip muscles during recovery. Mini squats, step-ups, stationary cycling, and resistance band walks can also help improve hip stability. Here’s how you can perform these exercises to speed up your recovery after a hip injury:

• Leg Raises: Lie on your back and lift the straight leg a few inches from the floor, then lower it slowly.
• Glute Bridges: Lie on your back straight with bent knees and raise your hips from the floor, then lower them back down.
• Clamshells: Lie on your side and lift your upper knee while keeping your feet together.
• Standing Hip Abductions: Stand upright and slowly move the affected leg out to the side, then return it to the starting position.
• Mini Squats: Perform a shallow squat and slowly return to a standing position.
• Step-Ups: Step onto a low platform with the affected leg, then step back down in a controlled manner.

How Can You Prevent Future Hip Injuries?

To avoid future hip dislocations, use assistive devices, wear supportive footwear, and maintain a healthy weight to reduce pressure on the hip. Before physical activities, you should also warm up properly, use correct movement techniques, and avoid sudden twisting. In some cases, your doctor may recommend wearing a brace after treatment to help keep the hip in a safe position. This additional support can help lower the risk of another dislocation while the surrounding tissues recover.

Besides that, remove tripping hazards at home, such as:

• Loose rugs and floor mats
• Electrical cords across walkways
• Clutter in hallways and living areas
• Unstable furniture or footstools
• Objects left on stairs or steps
• Uneven flooring or loose floorboards
• Pet toys and other small items on the floor
• Boxes or storage items blocking walkways

Get Immediate Treatment for a Dislocated Hip at Our Clinic in Massapequa!

After a hip dislocation, if you don’t receive treatment within 6 hours, the risk of permanent joint damage can increase significantly. Delayed treatment may also reduce blood flow to the femoral head, increasing the risk of avascular necrosis (bone death). This structural damage can affect your ability to walk, exercise, work, and perform other daily activities.

Our hip surgeon, Dr. Charles Ruotolo, at Total Orthopedics & Sports Medicine, will assess your hip dislocation and develop a personalized treatment plan to restore proper hip alignment and stability. If necessary, he will also perform emergency hip reduction or recommend advanced surgical intervention to restore joint mobility. Call 855-321-6784 or visit 5500 Merrick Road, Massapequa, NY 11758 to book your appointment.

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