The dislocating hip arthroplasty: prevention and treatment

The dislocating hip is functionally impairing and leads to patient dissatisfaction. The etiology is multifactorial and may include component malpositioning, soft tissue laxity, and component or anatomical impingement. Initial treatment of dislocation usually consists of closed reduction followed by the use of an abduction pillow or brace or a knee immobilizer, although evidence to support these actions is limited. Operative intervention is generally reserved for patients with more than 2 dislocations and should aim to correct the cause of dislocation using a simple algorithm. Proper component positioning is key to prevention of further dislocation, but other tools include modular implants, jumbo heads, and increased offset. Finally, constrained acetabular components may be considered if a patient fails one of the above surgical options.