Causes of failure after total hip arthroplasty: A narrative review of literatures

Innovations in materials and implant design, as well as refinement of procedures and countermeasures for various complications, have led to improved outcomes for patients undergoing total hip arthroplasty (THA). However, various issues remain. Here we performed a comprehensive review of literatures regarding clinical failure of THA and discuss the current situation regarding specific issues. A narrative review was conducted focusing on the various causes of clinical failure or complications after THA. Each cause or complication is listed according to time of occurrence, from the intraoperative period to the late stage post-surgery. For each specific condition requiring revision or further surgery, we summarize the important clinical information, including prevalence, diagnosis, risk factors, and treatment options. We focused on specific conditions that cause failure of THA, including periprosthetic joint infection, dislocation, malalignment/malposition, iliopsoas impingement, and other causes of pain after THA. We also discuss the prevalence, risk factors, diagnostic algorithm, and treatment options. Identifying possible causes of THA failure at each stage after surgery is important. In addition, clinicians need to understand that patients may have an unsatisfactory outcome despite perfect surgical technique and/or postoperative radiographs. •Comprehensive review of the literature regarding clinical failure of total hip arthroplasty (THA).•We focused on specific conditions that cause failure of THA.•We summarize prevalence, diagnosis, risk factors, and treatment options in each condition.