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The unstable total hip replacement

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Dislocation is one of the most common complications of total hip replacement – dislocation rate of 3.2%.

Despite increased experience with hip replacement, the overall rate has not yet changed. The risk of first-time dislocation as a function of time after the surgery is not well understood. But the risk of dislocation is highest during the first few months after hip replacement; however, first-time late dislocation can also occur many years after replacement.

In this paper, several risk factors were highlighted:

  • surgical approach
  • the diameter of the head
  • impingement
  • component malposition
  • insufficient abductor musculature

And also treatment options:

  • long-term bracing after closed reduction
  • component reorientation
  • capsulorraphy
  • trochanteric advancement
  • increasing offset
  • exchange of the modular head and the polyethylene liner
  • insertion of constrained liner.


Indian J Orthop. 2008 Jul-Sep; 42(3): 252–259.   

PMCID: PMC2739467   Copyright © Indian Journal of Orthopaedics F D’Angelo, L Murena, G Zatti, and P Cherubino Department of Orthopedics and Traumatology, University of Insubria, Varese – Italy Correspondence: Fabio D’Angelo, Department of Orthopedics and Traumatology, University of Insubria, Viale Borri 57, 21100 Varese, Italy. E-mail: fabio.dangelo@uninsubria.it