The prevention and treatment of dislocation following total hip arthroplasty: efforts to date and future strategies.

Abstract

Dislocation continues as one of the common complications following primary Total Hip Arthroplasty (THA). Considering revision THA, dislocation is also one of the leading causes of failure and the subsequent need for re-revision surgery. This article aims to highlight the efforts to date that surgeons have utilised together with the implants employed to both prevent and treat THA dislocation. A fundamental principal in the management of THA instability is identification of the risk factors for dislocation and these are considered in 5 subgroups; patient factors, surgeon factors, implant design, implant orientation and soft tissue factors. Risk stratification is proposed as a future method of deciding upon best treatment for those patients most at danger of THA dislocation and subsequent continued instability.