Instability after Total Hip Arthroplasty

This review focuses on the prevention of postoperative instability and describescurrent operative options that have the potential to significantly reduce the risk ofinstability and the necessity of post-dislocation management. The latest researchfindings are presented to improve the readers› grasp of this complex issue.Increasing evidence supports the use of larger femoral heads as the promisingpreventive material currently available, meticulous posterior capsular repair whena posterior approach is used, hip resurfacing and higher offset. Future research isneeded to more precisely determine the risk of instability associated with the useof postoperative patient restrictions and exercises, minimal incision surgery and computer-assisted navigation. Instability after total hip arthroplasty is troublesomefor the patient and challenging for the surgeon. This review provides the surgeonwith an opportunity to thoroughly understand the factors that may contribute toinstability after total hip arthroplasty, the operative strategies that can be used toprevent and treat postoperative instability and the necessity of developing a plan foroptimally preventing and managing dislocation.