Recurrent Posterior Hip Dislocations on a Cam-Type Femoroacetabular Impingement: A Case Report

Leclerc, J.; Belzile, Étienne L.

doi:10.1177/2325967118783671

Cited by 2 publications

(5 citation statements)

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“…3,18,23 It is thought that a cam lesion, present in 73% of 37 patients for whom it was reported in this review, may predispose a patient to instability by acting as a lever for the femoral head to dislocate or subluxate out of the acetabulum. 3,4,21,23,27,34,36 However, the true implications of this finding are currently incompletely understood, particularly in light of the high prevalence of radiographic changes of FAI in asymptomatic athletes. 3,4,18,21,23,24,27,34 Although the present review contributes to the understanding of hip dislocation and subluxation in athletes, it is not without its own limitations.…”

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

“…3,4,21,23,27,34,36 However, the true implications of this finding are currently incompletely understood, particularly in light of the high prevalence of radiographic changes of FAI in asymptomatic athletes. 3,4,18,21,23,24,27,34 Although the present review contributes to the understanding of hip dislocation and subluxation in athletes, it is not without its own limitations. The studies included are retrospective and mostly with small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

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Hip Dislocation and Subluxation in Athletes: A Systematic Review

et al. 2021

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Background: Hip dislocation is a rare occurrence during sports but carries serious implications for athletes. Purpose: To systematically review treatment strategies and outcomes for hip dislocation in athletes, with the ultimate goal of providing sports medicine physicians with the information necessary to appropriately treat and counsel patients sustaining this injury. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, MEDLINE, and Embase were searched for studies relating to hip instability and athletics from January 1, 1989 to October 1, 2019. Abstracts and articles were evaluated on the basis of predefined inclusion and exclusion criteria. Inclusion criteria were the following: (1) data from ≥1 patients, (2) native hip dislocation or subluxation occurring during sports, (3) patients aged at least 10 years, and (4) written in English. Exclusion criteria were (1) patients younger than 10 years; (2) nonnative or postoperative hip dislocation or subluxation; (3) a native hip injury without dislocation or subluxation; (4) patients with dislocation or subluxation secondary to neuromuscular, developmental, or syndromic causes; (5) dislocation or subluxation not occurring during sports; (6) patients with physeal fractures; or (7) review articles or meta-analyses. Data were recorded on patient demographics, injury mechanism, treatment strategies, and clinical and radiographic outcomes. Where possible, pooled analysis was performed. Studies were grouped based on reported outcomes. Meta-analysis was then performed on these pooled subsets. Results: A total of 602 articles were initially identified, and after screening by 2 reviewers, 27 articles reporting on 145 patients were included in the final review. There were 2 studies that identified morphological differences between patients with posterior dislocation and controls, including decreased acetabular anteversion ( P = .015 and .068, respectively), increased prevalence of a cam deformity ( P < .0035), higher alpha angles ( P≤ .0213), and decreased posterior acetabular coverage ( P < .001). No differences were identified for the lateral center edge angle or Tonnis angle. Protected postreduction weightbearing was most commonly prescribed for 2 to 6 weeks, with 65% of reporting authors recommending touchdown, toe-touch, or crutch-assisted weightbearing. Recurrence was reported in 3% of cases. Overall, 4 studies reported on findings at hip arthroscopic surgery, including a 100% incidence of labral tears (n = 27; 4 studies), 92% incidence of chondral injuries, 20% incidence of capsular tears, and 84% incidence of ligamentum teres tears (n = 25; 2 studies). At final follow-up, 86% of patients reported no pain (n = 14; 12 studies), 87% reported a successful return to play (n = 39; 10 studies), and 11% had radiographic evidence of osteonecrosis (n = 38; 10 studies). Conclusion: Various treatment strategies have been described in the literature, and multiple methods have yielded promising clinical and radiographic outcomes in patients with native hip dislocation sustained during sporting activity. Data support nonoperative treatment with protected weightbearing for hips with concentric reduction and without significant fractures and an operative intervention to obtain concentric reduction if unachievable by closed means alone. Imaging for osteonecrosis is recommended, with evidence suggesting 4- to 6-week magnetic resonance imaging and follow-up at 3 months for those with suspicious findings in the femoral head.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hip Dislocation and Subluxation in Athletes: A Systematic Review

et al. 2021

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“…По мнению некоторых авторов, существуют факторы, способствующие рецидиву вывиха: дисплазия ТБС, обширные разрывы суставной капсулы, повреждения суставной губы и наружных ротаторов бедра [80]. Другие исследователи считают причиной релюксации ФАИ [81]. Однако все данные по рецидивным вывихам бедра представлены описанием отдельных случаев и небольших серий, и оценить доказательное влияние какого-либо фактора на их возник-новение в настоящее время невозможно.…”

Section: осложнения и последствияunclassified

Traumatic Hip Dislocation: Lecture

Berezin

Bragina

Petrushin

2021

Traumatology and Orthopedics of Russia

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Traumatic hip dislocations occupy the fourth place among dislocations of various localizations and, as a rule, are the result of exposure to a high-energy traumatic agent. Such injuries are more often observed in young and middle-aged males. The main cause of hip dislocations is road accidents. The femoral head is more often dislocated posteriorly, but anterior dislocations are not casuistic and account for approximately 10%. Hip dislocations are often combined with acetabular fractures, while their fairly clear clinical picture in the presence of fractures can be leveled. Traumatic hip dislocations require urgent diagnosis and treatment. After the clinical examination of the patient, an x-ray of the pelvis and hip joints are performed. Radiographic diagnosis of hip dislocation remains relevant, but modern imaging methods allows to study the hip joint in more detail and identify concomitant injuries. The main treatment for hip dislocation is closed reduction. Early dislocation reduction and the absence of damage to the structures forming the hip joint are important for the treatment results prognosis. The further patient management tactics after the dislocation reduction is determined by the results of stress tests and the CT data. When confirming the instability and associated injuries of the hip joint anatomical structures, surgical treatment is indicated. Among the complications of hip dislocation: sciatic nerve damage, post-traumatic coxarthrosis, the femoral head avascular necrosis, heterotopic ossification. Current literature data indicates the importance of early diagnosis of dislocation-associated injuries of the hip joint and periarticular tissues. Early and comprehensive repair of all existing injuries is crucial for favorable outcomes. A number of therapeutic and diagnostic methods, primarily arthroscopy, show optimistic results, but need further study.

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Recurrent Posterior Hip Dislocations on a Cam-Type Femoroacetabular Impingement: A Case Report

Cited by 2 publications

References 24 publications

Hip Dislocation and Subluxation in Athletes: A Systematic Review

Hip Dislocation and Subluxation in Athletes: A Systematic Review

Traumatic Hip Dislocation: Lecture

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