How can we prevent dislocations after total hip arthroplasty?

Dislocation is one of the top three reasons why patients require revision surgery after total hip replacement.

Native hip dislocations typically result from high energy mechanisms, such as motor vehicle accidents. Given that the native femoral head is replaced with a smaller head during a hip replacement, dislocation after total hip replacement is more likely. The causes for dislocation after total hip replacement are multifactorial and fall into the broad categories of patient demographics, as well as iatrogenic and implant-related factors. In The Lancet Rheumatology, Setor Kunutsor and colleagues report a systematic review and meta-analysis

of 4 633 935 patients who had total hip replacements, analysing the variables that predispose patients to dislocation. The questions we must ask are: what can we do as clinicians to reduce the risk of dislocation in our patients undergoing total hip replacement? In fact, is it possible to eliminate dislocations altogether?