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World J Orthop 2012 August 18; 3(8): 122-130“ISSN 2218-5836 (online)

Instability after total hip arthroplasty

Brian C Werner, Thomas E Brown, Department of Orthopedic Surgery, University of Virginia, School of Medicine, Charlottes-ville, VA 22908, United States
Published online: August 18, 2012


Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after
well-planned surgery, a significant incidence of recur- rent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitivedisorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral
head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter.

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