Instability Following Total Hip Arthroplasty: Etiology and Treatment Options

Dislocation is a common complication following total hip arthroplasty. Risk factors can be classified as patient, surgery or implant related. Treatment of choice for first-time dislocations is closed reduction followed by immobilization. In case of recurrent dislocation, surgical intervention should be carried out according to the etiology of instability. First-line surgical options include trochanteric advancement/refixation, implant repositioning, and implantation of a larger sized head, longer neck or elevated rim liner. Further options such as a constrained cup or dual-mobility socket have been shown to significantly decrease the chance of dislocation.