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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Instability after total hip arthroplasty.

Brian C Werner1, Thomas E Brown

  • 1Brian C Werner, Thomas E Brown, Department of Orthopedic Surgery, University of Virginia, School of Medicine, Charlottesville, VA 22908, United States.

World Journal of Orthopedics
|August 25, 2012
PubMed
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Total hip arthroplasty (THA) instability is a common complication. Prevention during the initial surgery is crucial, as managing instability is challenging, even with revision options.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Instability is a frequent and serious complication following total hip arthroplasty (THA).
  • Optimal preoperative planning and index surgery are critical for preventing THA instability.
  • Managing existing THA instability presents significant challenges for even experienced joint surgeons.

Purpose of the Study:

  • To review the challenges and management strategies for instability after total hip arthroplasty.
  • To emphasize the importance of prevention through meticulous index surgery.
  • To outline the available options for managing recurrent THA instability when conservative measures fail.

Main Methods:

  • Literature review of existing studies on THA instability.
  • Analysis of non-operative and surgical management techniques.
Keywords:
Bipolar arthroplastyConstrained linerInstabilityLarge femoral headRevisionTotal hip arthroplasty

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  • Discussion of factors influencing THA stability and revision strategies.

    • Main Results:

    • Non-operative management can be successful for stable, well-positioned components without neurocognitive issues.
    • Recurrent instability can persist even after well-planned primary THA.
    • A range of surgical interventions exist for recalcitrant THA instability.

    Conclusions:

    • Preventing THA instability through careful initial surgery is paramount.
    • A stepwise approach, from non-operative management to surgical revision, is necessary for unstable THA.
    • Surgical options for instability include component revision, modular exchange, and advanced techniques like constrained liners.