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(29 to 55) after failed revision surgery. The ideal solution to instability is prevention, achieved using optimal index surgery 4 . This article outlines the aetiology of hip dislocation and provides the surgeon with an algorithm for the
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Introduction Despite the fact that total hip arthroplasty (THA) is commonly reported with successful results, instability remains a disappointing complication and one of the most common reasons for revision. Prevalence of instability has been
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different for each patient and likely multifactorial ( 3 , 5 , 6 , 7 ). The effect of cup orientation in total hip arthroplasty (THA) outcome was further studied in the setting of instability. Numerous authors, in the recent years, have challenged the
Department of Surgery, Albany Health Campus, Albany, Australia
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Department of Surgery, Université de Montréal, Montréal, Québec, Canada
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. Currently, two factors may compromise this achievement: hip range of motion (ROM) restrictions and hip instability. One option addressing these two problems is the dual mobility (DM) articulation. This very old French invention, used since 1974 by Gilles
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, the demand for THA will grow, with the number of THAs performed in the United States projected to increase by 174% by 2030 compared to 2005. 1 However, THA is not without risk. Total hip arthroplasty instability is a disabling condition and
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Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
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Follow-up MR arthrography conducted 11 months later showed that the superior capsule injury had healed, but the iliofemoral ligament defect remained. This defect creates the potential for anterior hip instability, as has been previously reported in
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repair. 53 The ideal treatment of borderline developmental dysplastic hip (BDDH) is currently a subject of controversy. It is paramount to understand the underlining problem of the individual hip and distinguish instability (dysplasia) from FAI as
Academic Unit of Bone Metabolism, University of Sheffield Medical School, Sheffield, UK
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
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Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
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deformities are far more common. 5 Postural instability predisposes Parkinson’s individuals to sustain a fall, whereas reduced bone mineral density is the sequelae of vitamin D deficiency, physical impairment and immobilization induced hypercalcaemia. 6
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Leeds Institute of Rheumatic Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, UK
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Leeds Institute of Rheumatic Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, UK
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Leeds Institute of Rheumatic Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, UK
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spacers also less frequently require extensile surgical approaches upon second-stage surgery ( 67 , 69 , 78 , 79 ). Instability and other complications Hip Recognised complications of dynamic spacers for the hip include dislocation, spacer
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has been described as the single most important factor in determining the risk of dislocation following THA. 9 Furthermore, instability and dislocation after primary THA is the most common single reason for revision surgery, accounting for 22
