Operative and non-operative treatment options for dislocation of the hip following total hip arthroplasty

B a c k g r o u n d Dislocation following hip replacement is associated with significant morbidity and functional cost. The cause is usually multifactorial. A variety of treatment options are available which can broadly be classified into operative and non-operative. O b j e c t i v e s To determine the best methods of treatment of recurrent dislocation following total hip replacement. S e a r c h s t r a t e g y The following databases were searched until August 2006: MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials ( CENTRAL), Health Technology Assessment database ( HTA), Database of Abstracts of Reviews of Effectiveness ( DARE), International Standard Randomised Controlled Trial Number Register ( ISRCTN), and MetaRegister of Controlled Trials ( mRCT). S e l e c t i o n c r i t e r i a Randomised and quasi-randomised trials comparing operative and non-operative treatments for recurrent dislocation following total hip replacement. D a t a c o l l e c t i o n a n d a n a l y s i s Two independent reviewers applied the inclusion criteria to identified studies. M a i n r e s u l t s Searches identified 269 studies. None fulfilled the inclusion criteria. A u t h o r s ' c o n c l u s i o n s The authors invite researchers to perform RCTs comparing different treatment options for recurrent dislocation of the hip. The heterogeneity of the population and variety of underlying causes would favour a multi-centre study to achieve an adequate sample size.