A 79-year-old woman has had two closed reductions for posterior dislocation of a well-positioned total hip replacement performed through a posterior approach within 6 months of surgery. Abductor strength is good and radiographs show no component malposition or loosening. The most appropriate next intervention is:

• A Exchange of the femoral head to the largest available diameter
• B Continued abduction bracing for three months
• C Revision to a dual mobility acetabular construct ✓
• D Open reduction with capsular plication alone

Explanation

Recurrent dislocation with well-fixed, well-positioned components warrants revision addressing instability directly. C dual mobility bearing, a polyethylene liner that articulates both with the femoral head and the acetabular shell, provides a large effective head diameter and markedly lowers redislocation rates, making it the preferred choice in elderly patients with recurrent instability. Simple bracing has failed twice, isolated capsular plication has poor durability, and a modest head exchange does not match the jump distance of a dual mobility construct.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.