Prevention of Dislocation After Total Hip Arthroplasty

J Arthroplasty. 2018 May;33(5):1316-1324. doi: 10.1016/j.arth.2018.01.047. Epub 2018 Mar 7.


Background: Prevention of dislocation after primary total hip arthroplasty (THA) begins with patient preoperative assessment and planning.

Methods: We performed a literature search to assess historical perspectives and current strategies to prevent dislocation after primary THA. The search yielded 3458 articles, and 154 articles are presented.

Results: Extremes of age, body mass index >30 kg/m2, lumbosacral pathology, surgeon experience, and femoral head size influence dislocation rates after THA. There is mixed evidence regarding the effect of neuromuscular disease, sequelae of pediatric hip conditions, and surgical approach on THA instability. Sex, simultaneous bilateral THA, and restrictive postoperative precautions do not influence the dislocation rates of THA. Navigation, robotics, lipped liners, and dual-mobility acetabular components may improve dislocation rates.

Conclusions: Risks for dislocation should be identified, and measures should be taken to mitigate the risk. Reliance on safe zones of acetabular component positioning is historical. We are in an era of bespoke THA surgery.

Keywords: complication; dislocation; instability; revision hip arthroplasty; total hip arthroplasty.

Publication types

  • Review

MeSH terms

  • Acetabulum / surgery*
  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Body Mass Index
  • Female
  • Femur Head / surgery
  • Hip Dislocation / surgery
  • Hip Prosthesis / adverse effects*
  • Humans
  • Joint Dislocations / prevention & control*
  • Joint Dislocations / surgery
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Range of Motion, Articular