Section: Overview
Coxofemoral (hip dislocation) luxation is dislocation of the head of the femur, which is the ball of the thigh bone, out of the socket of the pelvis (acetabulum). Hip dislocations can develop under a number of circumstances. Prominent reasons are trauma and pre-existing hip problems such as hip dysplasia.
Hip dislocation occurs when the round ligament of the femoral head, the structure that normally tethers the femoral head within the acetabulum, completely ruptures or pulls away from its attachment.
There are no breed, age, or sex susceptibilities for this problem.
The potential long-term effects of hip luxation range from none, if the problem is addressed early, to severe arthritis in the joint if there is excessive delay in treatment.
What to Watch For
Inability to bear full weight on the limb
Excessive mobility of the limb
Crackling noise (crepitus) at the joint
Shortening of the limb
Diagnosis
Diagnostic tests that may be required to confirm the diagnosis and determine the presence of concurrent diseases or abnormalities, include:
A thorough physical examination
Chest radiographs
Complete orthopedic examination
Radiographs of the pelvis
Laboratory tests are not required to make the diagnosis, but may be indicated depending on your animal's age and condition.
Treatment
Treatment may consist of one or more of the following:
Emergency care for concurrent problems caused by the trauma.
Closed reduction. This is the replacement of the head of the femur into the socket without surgery.
Open reduction. This is the surgical replacement and stabilization of the head of the femur into the socket.
Open reduction requires that a surgical approach to the hip joint is made to allow direct visualization of the bones and joint capsule. The torn round ligament of the femoral head is removed and the head of the femur is replaced into the acetabulum.
The surgeon may use one of the following methods for maintaining the position and preventing reluxation:
Joint capsule reconstruction, which is repair of the torn joint capsule
Prosthetic joint capsule, which is the use of suture material between acetabular rim and femur to prevent the femoral head from moving out of joint
Toggle pin, which is the placement of a piece of large suture material within the joint to mimic the function of the damaged round ligament
Greater trochanter translocation, which consists of redirecting the pull of the large hip muscles to force the head of the femur into the acetabulum
De Vita pin, which is the placement of a metal bar across the rim of the acetabulum to prevent the femoral head from moving out. The pin needs to be removed in several weeks through a small incision behind the animal's thigh. This technique may also be employed in a "closed" fashion, without the need for an incision.
After surgery, the limb may be placed in a sling.
Home Care and Prevention
Take your cat to a veterinarian as soon as possible after any trauma for immediate evaluation.
After closed reduction, the limb will be placed in a sling and your cat's activity will need to be restricted for several weeks to allow the joint to heal.
If an open reduction technique is used, the leg may be placed in a sling and your cat's activity restricted. Additionally, the skin incision will be monitored during the healing process.
Radiographs may be repeated in several weeks to make sure the hip is still in the joint.
Many traumatic events are true accidents and thus unavoidable. Keeping cats indoors will reduce the chances of them being struck by a motor vehicle.
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