Instability after total hip arthroplasty

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