The decision to do a bipolar is probably correct. the postoperative dislocation and repeated instabilty was surprising. May be a touch of decrease offset added to the instability. If these were a tripolar cup one could imagine an impingement between the neck and the large polyhead could contribute to instability.
intraop the patient had global instabilty due to possible wrong stem versiosn and soft tissue laxity. we revised the stem with a cememt on cement smaller stem causing smaller offset and still having laxity. so intraop we decided to go for a constrained liner as she was low demand.
The final post op xrays with a the +3 head and constrained liner stabilised the hip. The cup is a touch too medial which could have been avoided. the other option would have been a tripolar cup which could dislocate too due to impingement. The constrined liner could dissociate at the stem head junction if tested as well as wear more quickly
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