Dislocation of THA should not come as a surprise if it is considered that the natural and symptomatic joint is replaced by an artificial, neuropathic spacer. Absence of sensory input works both ways: freedom from pain but lack of warning of an impending dislocation – especially in the early post-operative period before healing of the deep soft tissues.

Recurrent dislocation undermines the patient’s confidence and frustrates the surgeon who may seek refuge in alternative methods and designs. Exposures avoiding trochanteric osteotomy and use of larger diameter heads are intuitively considered to be likely immediate solutions. Both present new challenges but may appear more attractive than to follow what is a well established method in order to expand the understanding and improve on the results already achieved.