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World J Orthop. Aug 18, 2012; 3(8): 122-130
Published online Aug 18, 2012. doi: 10.5312/wjo.v3.i8.122
Instability after total hip arthroplasty
Brian C Werner, Thomas E Brown
Brian C Werner, Thomas E Brown, Department of Orthopedic Surgery, University of Virginia, School of Medicine, Charlottesville, VA 22908, United States
Author contributions: Werner BC and Brown TE designed and performed the research; Werner BC drafted the paper; Brown TE selected the images; both authors revised the manuscript.
Correspondence to: Brian C Werner, MD, Department of Orthopaedic Surgery, PO Box 800159, University of Virginia, Charlottesville, VA 22908, United States.
Telephone: +1-434-2430278 Fax: +1-434-2430242
Received: October 24, 2011
Revised: July 1, 2012
Accepted: August 7, 2012
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 recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. 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.

Keywords: Instability, Total hip arthroplasty, Revision, Constrained liner, Bipolar arthroplasty, Large femoral head