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INSTABILITY: A QUESTION OF BALANCE – THE HIP



Abstract

Dislocation of a total hip replacement is a devastating event from the patient perspective. Patient (neuromuscular disease, DDH, revision), surgical approach, soft tissue balancing, and implant factors (head-neck ratio, neck design, offset) all play a role. Most hip dislocations occur early, but dislocation can often occur late due to wear-induced head/neck impingement. Early reduction and preventative measures are effective in preventing further dislocation in about 70% of patients. Revision surgery for dislocation is effective in only three quarters of patients. In elderly, low demand patients, constrained/ capture cups are an effective option. Prevention of dislocation is obviously the key and involves patient selection, preoperative planning, leg length/offset restoration, and choice of a total hip replacement, which minimises head/neck impingement.

The abstracts were prepared by Mrs Dorothy L. Granchi, Course Coordinator. Correspondence should be addressed to her at PMB 295, 8000 Plaza Boulevard, Mentor, Ohio 44060, USA.