Prevention and Management of Instability After Total Hip Arthroplasty

Although total hip arthroplasty is a highly effective surgery, postoperative hip instability is a catastrophic complication with a high degree of patient morbidity. A thorough understanding of hip biomechanics is necessary to restore native anatomy and achieve a stable hip during the primary arthroplasty. A comprehensive preoperative evaluation can identify high-risk patients and allows the clinician to alter their surgical plan accordingly. Intraoperative assessments of stability should be employed routinely to correct any surgical misjudgments. Knowledge of implant options and diagnostic accuracy are imperative to obtaining a stable hip after revision for instability. The purpose of this review article is to discuss the keys to the prevention of hip instability and some management strategies for the recurrently dislocating total hip arthroplasty.