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The literature describes several risk factors, including surgeon-, patient-, and implant-related factors. Knowledge of these factors is essential to preventing and managing instability cases. Preventive treatment involves preoperative planning, adequate component positioning, normal hip biomechanics reestablishment, risk factor identification, and proper implant selection. Approximately two thirds of dislocation episodes are treatable with non-surgical treatment with closed reduction, education, and muscle strengthening. One third of the cases develop recurrent dislocations and require surgical intervention. Revision surgery should target the cause of instability. When necessary, consider special implants, such as dual-mobility acetabular components, polyethylene-based lipped acetabular liners, constrained acetabular inserts, or large-diameter prosthetic heads. Technological advances in robotic surgery and the understanding of the biomechanics of spinopelvic swing-related dislocation are promising current topics that may improve the prevention and treatment of instability.<\/jats:p>","DOI":"10.1055\/s-0045-1810122","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:01:42Z","timestamp":1765411302000},"page":"001-008","source":"Crossref","is-referenced-by-count":1,"title":["Instability Prevention and Treatment in Total Hip Replacement"],"prefix":"10.1055","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0780-6811","authenticated-orcid":false,"given":"Bruno Alves","family":"Rudelli","sequence":"additional","affiliation":[{"name":"Institute of Orthopedics and Traumatology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (IOT-HCFMUSP), S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Seiji Mazzi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Institute of Orthopedics and Traumatology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (IOT-HCFMUSP), S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Rudelli","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Torres","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Institute of Orthopedics and Traumatology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (IOT-HCFMUSP), S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helder de Souza","family":"Miyahara","sequence":"additional","affiliation":[{"name":"Institute of Orthopedics and Traumatology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (IOT-HCFMUSP), S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique Melo de Campos","family":"Gurgel","sequence":"additional","affiliation":[{"name":"Institute of Orthopedics and Traumatology, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (IOT-HCFMUSP), S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.1016\/j.arth.2018.01.047","article-title":"Prevention of Dislocation After Total Hip Arthroplasty","volume":"33","author":"F E Rowan","year":"2018","journal-title":"J Arthroplasty"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"509","DOI":"10.2147\/CLEP.S99498","article-title":"The Danish Hip Arthroplasty Register","volume":"8","author":"P H Gundtoft","year":"2016","journal-title":"Clin Epidemiol"},{"issue":"07","key":"ref4","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.1016\/j.arth.2017.02.046","article-title":"Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013","volume":"32","author":"C U Gwam","year":"2017","journal-title":"J Arthroplasty"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5301\/hipint.5000318","article-title":"Dislocation after total hip replacement - there is no such thing as a safe zone for socket placement with the posterior approach","volume":"26","author":"A J Timperley","year":"2016","journal-title":"Hip Int"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1097\/01.blo.0000218751.14989.a6","article-title":"Revision hip arthroplasty for late instability secondary to polyethylene wear","volume":"447","author":"J Parvizi","year":"2006","journal-title":"Clin Orthop Relat Res"},{"issue":"01","key":"ref7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.2106\/00004623-200401000-00003","article-title":"The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty","volume":"86","author":"D J Berry","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"07","key":"ref8","doi-asserted-by":"publisher","first-page":"4491","DOI":"10.1007\/s00402-022-04678-w","article-title":"Did the dislocation risk after primary total hip arthroplasty decrease over time? 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