Prevention and Management of Instability After Total Hip Arthroplasty.

J Am Acad Orthop Surg · Nov 01 2025 · Review

Dunleavy ML, Minutillo GT, Shaw JH, Paprosky WG

From the Princeton Orthopaedic Associates, Princeton, NJ (Dunleavy), IL (Paprosky)

Adult Reconstruction

SUMMARY — THE REDUCTIONThis review covers preventing instability after total hip arthroplasty through restoring biomechanics, identifying high-risk patients, and intraoperative stability checks, plus management strategies for recurrent dislocation and revision for instability.
Abstract, as published

Although total hip arthroplasty is a highly effective surgery, postoperative hip instability is a catastrophic complication with a high degree of patient morbidity. A thorough understanding of hip biomechanics is necessary to restore native anatomy and achieve a stable hip during the primary arthroplasty. A comprehensive preoperative evaluation can identify high-risk patients and allows the clinician to alter their surgical plan accordingly. Intraoperative assessments of stability should be employed routinely to correct any surgical misjudgments. Knowledge of implant options and diagnostic accuracy are imperative to obtaining a stable hip after revision for instability. The purpose of this review article is to discuss the keys to the prevention of hip instability and some management strategies for the recurrently dislocating total hip arthroplasty.

Featured in the 2026-10-04 issue.

← Periprosthetic Femoral FracturesManagement and outcome of displaced acetabular fractures in t… →

The Reduction is a free email digest of newly published orthopaedic literature — a handful of new papers in the subspecialties you choose, each summarized like this one. Subscribe free or browse the archive.