One of the most common complications after total hip arthroplasty is instability. This study reviewed the recent literature concerning the indications, contraindications, and results of recent studies using both constrained liners and large femoral heads to treat instability after total hip arthroplasty. We also report on the results of a series of 41 patients (52 hips) considered being at high risk for dislocation who were treated with large-diameter metal-on-metal bearings and who were compared with a matched group of hips treated with standard-size metal-on-polyethylene bearings. The large-diameter femoral head group had no dislocations at a minimum follow-up of 24 months, whereas the standard-size group had 2 dislocations. We support the use of large femoral heads to treat instability in a wide variety of patients because of the increased stability, decreased wear of modern metal-on-metal designs, increased range of motion, and variety of revision options.

Polls results

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
85% Article relates to my practice (12/14)
7% Article does not relate to my practice (1/14)
7% Undecided (1/14)

Will this article lead to more cost-effective healthcare?

71% Yes (10/14)
21% No (3/14)
7% Undecided (1/14)

Was this article biased? (commercial or personal)

7% Yes (1/14)
85% No (12/14)
7% Undecided (1/14)

What level of evidence do you think this article is?

14% Level 1 (2/14)
7% Level 2 (1/14)
50% Level 3 (7/14)
21% Level 4 (3/14)
7% Level 5 (1/14)