subluxation of the hip
Last reviewed 01/2018
Subluxation of the hip exists when part of the joint surface is still in apposition. It can be a sequel of unsuccessfully treated CDH, or it may be a lesser variant of congenital dislocation.
The acetabulum is usually shallow and of greater slope than normal such that only the central area of the femoral head transmits forces.
Clinically, in the child abduction may be restricted before there is a definite progression to limp and positive Trendelenburg's sign. In middle age, osteoarthritis and instability may arise and rapidly advance.
Treatment in the infant involves splinting in abduction. Beyond one year, a Chiari osteotomy of the pelvis, an acetabular shelf operation or high femoral osteotomy may be necessary. In adults, consider replacement arthroplasty.