Abstract
For some patients, total hip arthroplasty (THA) continues to be complicated by postoperative instability and dislocation. The risk of dislocation is markedly higher in patients with predisposing conditions, including coexisting spinal pathology. In these patients, implant design and choice may offer added stability. Larger femoral heads, dual mobility constructs, constrained acetabular liners, and elevated acetabular liners offer enhanced stability in patients who are at risk for postoperative instability. Similarly, pre-operative templating, surgical approach, and surgical techniques such as trochanteric advancement may also influence stability. This review will discuss the evidence, advantages, and disadvantages of the various implant options and surgical techniques for enhancing stability in high risk patients after THA.
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