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My father had a hip replacement that went bad. After they replaced the replacement, the new hip started dislocating on him. What do we do now?

Hip dislocation after a primary (first) or revision total hip replacement is a fairly common problem. Revision refers to any future operations to repair or replace the implant.

The rates of dislocation after hip replacement have improved over the years. It's estimated that about one to three per cent of patients will have a dislocation after the first hip replacement. Three to five times that number will dislocate after a revision.

Surgeons are actively working with scientists to find ways to reduce this complication rate. The cost of this event is dramatic, both for the patient and for society.

It may be possible to prevent further dislocations with careful use of the leg. This means avoiding certain positions and movements. A rehab program under the supervision of a physical to strengthen the muscles around the hip is also in order. When structural instability is mild to moderate, then mechanical stability through proper tissue tension may be able to achieve the stability needed.

If hip dislocation still occurs after conservative care, further surgery may be needed. It may be possible to revise the hip again. However, many older adults refuse this option. Joint fusion is another final approach to consider. This is done most often when chronic dislocation develops, resulting in pain and increased falls.

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