Which THA approach is associated with a higher dislocation risk?

• A. Posterior approach
• B. Anterior approach
• C. Lateral approach
• D. Anterolateral approach

Answer: (A)

The main concept here is how the surgical approach in total hip arthroplasty affects the risk of postoperative hip dislocation. The posterior approach disrupts the posterior capsule and short external rotator muscles, which are key stabilizers of the hip. Because these structures are not preserved or securely repaired, the hip is more susceptible to dislocation, especially when the leg is flexed, adducted, and internally rotated—a common position during daily activities and in the early postoperative period.

The anterior approach, by preserving those posterior stabilizers, tends to maintain more inherent stability and thus has a comparatively lower dislocation risk. Lateral and anterolateral approaches mainly impact the abductor mechanisms; they can cause abductor weakness or limp but are not as strongly associated with dislocation as the posterior approach.

So, the approach most associated with higher dislocation risk is the posterior approach.