Instability in total hip arthroplasty: A literature review

Abstract

To introduce prevention and treatment methods for instability after total hip arthroplasty (THA) on the basis of the results of several recent studies. We comprehensively summarized and evaluated the results of several studies on the frequency, causes, countermeasures, and treatments after THA. We found that surgeon experience, mobility of the lumbosacral spine, and femoral head size influence the dislocation rate after THA, and that dual-mobility acetabular components, lipped liners, and intraoperative support systems, including navigation and robotics, can decrease the dislocation rate. Dual-mobility and lipped liners improve stability after THA; however, their indications should be carefully considered. Judicious use of postoperative mobility restriction may benefit some patients. • Many factors contribute to dislocation after primary THA. • Intraoperative support systems can decrease the dislocation rate. • Prevention of dislocation requires individualized therapeutic strategies.