Instability and dislocation of a hip replacement

An implant stays in place thanks to the shape of the components, the capsule and the surrounding muscles. When one of these falls short, instability develops. In the worst case the head comes fully out of the socket: a dislocation.

Possible causes:

• The position of the cup or stem is not optimal
• Weak gluteal muscles or a gluteal tendon tear
• A lax capsule or scar tissue after previous surgery
• A head diameter that is too small
• A stiff lower back or pelvis, forcing the hip into extreme positions

Muscle-sparing techniques through the direct anterior approach reduce this risk, because the muscles and tendons at the back stay intact.

• The feeling that the hip is giving way or is not reliable
• An audible click or jolt with certain movements
• A true dislocation: sudden severe pain, a shortened leg and inability to move
• Fear of bending, getting into a car or sitting in a low chair

With a suspected dislocation, urgent emergency care is needed.

• A dislocation is first put back into place under anaesthesia (reduction)
• An analysis with CT follows to measure the position of the components
• With repeated dislocations, a revision with a larger head, an adjusted position or a dual mobility cup helps
• Restoring the gluteal muscles and targeted physiotherapy are a fixed part of the approach

Not sure where your complaints come from? Use the symptom explorer or book an appointment with one of our hip surgeons.