Late instability following total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Geriatric Medicine

Background:

• Instability is a frequent complication following total hip arthroplasty (THA).
• Late instability, defined as occurring ≥5 years post-THA, contrasts with early dislocation and typically necessitates surgical treatment.
• The incidence of late instability may be underestimated, increasing with longer follow-up durations.

Purpose of the Study:

• To review published literature on late hip instability after THA.
• To present institutional experience in managing late dislocations attributed to polyethylene wear.
• To elucidate multifactorial etiologies of late hip instability.

Main Methods:

• Synopsis of existing studies on late hip instability.
• Review of institutional cases of late dislocation post-THA.
• Analysis of polyethylene wear as a cause of late instability.

Main Results:

• Late instability is a significant complication of THA, often requiring surgical intervention.
• Multifactorial causes include component malposition, trauma, muscle mass decline, neurological impairment, and polyethylene wear.
• Polyethylene wear is identified as a specific etiology for late dislocation in the reviewed cases.

Conclusions:

• Late instability following THA is a complex issue with rising incidence.
• Polyethylene wear represents a critical factor in the pathogenesis of late dislocations.
• Further research and refined treatment protocols are essential for managing late hip instability.