الفهرس 
Surgical Approach in Total HipOnly 14 pages are availabe for public view
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Abstract
Dislocation is one of the most common complications after total hip arthroplasty (THA) and also it is one of the most serious and painful complications that need urgent and careful interference (Von koch M 2002).
Risk patients include those with neuromuscular and cognitive disorders, patient non-compliance, and those with previous hip surgery (Berry DJ 1999).
Surgical considerations that must be addressed include approach, soft-tissue tension, component positioning, impingement, head size, acetabular liner profile, and surgeon experience ( Grey A Erens 2006).
Recent improvements in posterior soft-tissue repair after primary THA have shown a reduced incidence of dislocation (Callaghan J.J 2001).
When dislocation occurs, a thorough history, physical examination, and radiographic assessment help in choosing the proper intervention. Closed reduction usually is possible, and non surgical management frequently succeeds in preventing recurrence (Nelson CL 1999).
When these measures fail, first-line revision options should target the underlying etiology. This most often involves tensioning or augmentation of soft tissues, as in capsulorrhaphy or trochanteric advancement; correction of malpositioned components; or improving the head-to-neck ratio. If instability persists, or if a primary THA repeatedly dislocates without a clear cause, a constrained cup or bipolar femoral prosthesis may be as effective as a salvage procedure (Beaule P 2002),( Khan RJK 2006).