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Understanding the Unstable Total Hip Replacement

Total hip replacement (THR) surgeries are usually very successful in relieving pain and restoring function. But from one to three percent of artificial hips end up dislocating. This article discusses the reasons behind THR dislocation. The authors focus on understanding the causes of the instability. An unstable THR can be caused by patient factors or surgical factors.

Patient factors include:

  • Patient age and possibly gender.

  • The medical reason that a THR was needed.
  • Other health problems, especially if they affect the bones or soft tissues of the hip.

    Surgical factors include:

  • Whether the surgeon used an anterior (front) or posterior back approach.
  • Design and positioning of the artificial joint.
  • Whether or not the soft tissues around the joint were repaired.

    The authors stress that surgeons must identify the cause of instability before they can come up with an effective treatment plan. The article gives guidelines for surgeons to use when diagnosing problems with an unstable THR. The authors note that dislocations that happen soon after THR are usually treated much differently than dislocations that happen later.

    The article discusses bracing. It reviews the best types of implants and procedures to use for revision surgeries. The article also discusses newer techniques and technologies that may be useful in successfully treating the unstable THR.

    • Reference: 

    Douglas E. Padgett, MD, and Hideki Warashina, MD. The Unstable Total Hip Replacement. In Clinical Orthopaedics and Related Research. March 2004. Vol. 420. Pp. 72-79.

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