Abstract

Recurrent instability after primary or revision total hip arthroplasty is a difficult problem. Treatment of those who fail conservative management with a brace should start with optimizing acetabular and femoral component position, restoring femoral offset and abductor tension, and removing any bony or soft tissue sources of impingement. The next step in our treatment algorithm is to use a large-diameter femoral head or to create an unconstrained tripolar articulation. If these steps fail, or the abductor musculature is too deficient, then we will consider using a constrained acetabular liner as a matter of last resort.

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