Total hip arthroplasty (THA) is widely celebrated as the “operation of the century,” boasting high survival rates and stellar patient satisfaction. Yet, despite decades of innovation, the devastating complication of postoperative dislocation continues to plague the field. Dislocation is reported to occur in up to 10% of primary THAs and remains a leading cause for aseptic revision in the United States.
The posterior surgical approach, favored for its excellent visibility, has historically been scrutinized for higher dislocation rates compared to anterior approaches. However, recent advancements in highly cross-linked polyethylene have fundamentally changed the mechanical equations of THA. These stronger, thinner liners allow surgeons to utilize significantly larger femoral heads, which provide a greater arc of motion before impingement and an increased “jump distance” to resist dislocation. We evaluated dislocation rates following primary THA, as large femoral heads and select dual-mobility bearings were introduced into a contemporary posterior approach practice.
