September 21, 2021
Washington quarterback Ryan Fitzpatrick suffered a hip subluxation in the team's Week 1 loss to the Los Angeles Chargers, according to NFL Network Insider Ian Rapoport. Fitzpatrick won't be going under the knife following his significant hip injury, but the Washington quarterback is still expected to miss about half of the 2021 season. The 38-year-old quarterback is handling his injury "non-surgically," opting for rehab instead of surgery. Here are five things to know about Fitzpatrick's injury.
The Hip Joint Is An Inherently Stable Joint
The hip is a ball-and-socket joint but unlike the shoulder, the acetabulum (socket) is larger and covers a larger surface area of the femoral head (ball). In order for a hip joint to dislocate, it takes much more force to dislodge the femoral head from the acetabulum.
Subluxation vs. Dislocation
Ryan Fitzpatrick's hip subluxed — which means that the hip suffered a near dislocation event. When the hip dislocates, it will cause a tear of the labrum and/or capsule and in some cases, there may be a fracture to the rim of the acetabulum along with the torn labrum. With a subluxation event, the soft tissue may be injured without a complete tear.
If there is a dislocated hip on the field, the player needs to be taken off the field and evaluated with X-rays and reduced (put back in the socket) as soon as possible. After the hip is placed back in the socket, then a CT scan is needed to confirm that the hip is reduced, and there are no cartilage or bone fragments are in the joint. The player is generally placed on crutches on protected weight bearing to reduce the amount of weight on the hip joint. If there is an accumulation of blood in the joint, the blood can be aspirated to reduced pressure in the joint.
Operative vs Non-Operative Management
Non-operative treatment was recommended for Ryan's hip due to a subluxation event. Typically, a follow-up MRI will be performed to ensure that the hip is healing. Operative treatment can be considered acutely if there are fractures or loose bone or cartilage fragments in the hip joint. If there is a torn labrum, arthroscopic surgery can be considered for refixation.
Long Term Outlook
Due to the high energy force to sublux or dislocate the hip, there is a chance of avascular necrosis (AVN) to the hip joint at some point in the future. In AVN, an area of the femoral head may lose blood supply and that area of bone will become dead, and eventually lead to osteoarthritis.
About Shane J. Nho, M.D., M.S.
Dr. Nho's practice is focused on sports medicine and arthroscopic treatment of the hip, shoulder, and knee. He is the director of the Hip Preservation Center at Rush University Medical Center. Dr. Nho has been actively involved in research throughout his medical career and has published numerous scientific and clinical articles in the area of hip, shoulder, and knee reconstruction. He is co-head of the Hip Study Group at Rush which is a multidisciplinary group of clinicians and scientists to conduct research directed at studying hip joint preservation and clinical outcomes after hip surgery.