title: Surgical dislocation of the hip: evolving indications.
abstract: BACKGROUND
  Femoroacetabular impingement (FAI) is a condition that has become increasingly identified as abnormal, repetitive abutment of the proximal femur and acetabular rim. Safe surgical dislocation of the hip has been popularized as a technique that allows surgeons to not only improve joint preservation procedures but also understand disease patterns more clearly.
  
  
  OBJECTIVE
  We describe the technique of surgical dislocation as well as review the indications, results, and complications that are associated with the procedure. We also present various case examples to highlight this technique.
  
  
  METHODS
  We performed a systematic review of the literature to define the indications, clinical outcomes, and complications associated with surgical dislocation of the hip for the treatment of FAI.
  
  
  RESULTS
  Clinical success rates vary in the literature between 64% and 96% of patients with good results, and conversion to total hip arthroplasty ranging between 0% and 30% in patients who underwent FAI treatment with surgical dislocation. Reported major complication rates have ranged from 3.3% to 6%, most commonly in the form of trochanteric nonunion, neurapraxia, or heterotopic ossification.
  
  
  CONCLUSIONS
  FAI deformities encompass a wide spectrum of disease patterns. Surgical dislocation allows full access to the hip in addition to observing its pathomechanics. Strict adherence to proper technique allows the surgeon to minimize complication rates while treating the deformity at hand.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Hospital Plaza, Suite 11300, West Pavilion, Campus Box 8233, St Louis, MO 63110 USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Ross
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Hospital Plaza, Suite 11300, West Pavilion, Campus Box 8233, St Louis, MO 63110 USA.
authors.forename: Perry L
authors.initials: PL
authors.lastname: Schoenecker
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Hospital Plaza, Suite 11300, West Pavilion, Campus Box 8233, St Louis, MO 63110 USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
keywords: FAI; SCFE; femoroacetabular impingement; hip dislocation; perthes