Current Trends in Total Hip Arthroplasty
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2007, Vol 9, Issue 1
Abstract
As we come close to 20 years of widespread use of uncemented total hip arthroplasty (THA) several successful implants have been well established. Excellent short term and long term results have been demonstrated and uncemented fixation is regarded as the standard procedure for younger patients undergoing THA in most parts of the world.However, expectations regarding hip replacement are continuously changing, as we face an increasing number of young and active patients undergoing hip arthroplasty. The complication rate, including postoperative dislocation is expected to be close to zero, postoperative rehabilitation should be ever faster, wear should be low even in active patients, durability and long term survival should be high. On the other hand, demographic changes in aging societies lead to an increased need for cost-effective total hip replacement for the low-demand trauma patient.Several developments have been made to meet the expectations and needs of high demand patients. Modern THA bearings such as ceramic-ceramic articulations and other improved PE and metal materials provide high durability and low wear, if good alignment of the implant components can be achieved. Navigation technology has been introduced in total hip arthroplasty to ensure a perfect component positioning without outliers and concomitant risk of increased wear and implant failure. Minimal and less invasive approaches are becoming increasingly popular in order to facilitate rehabilitation and fast-track surgery in younger patients. Again, navigation provides assistance for implant positioning in procedures with limited surgical exposure and limited visibility.New bone preserving implants like surface replacement or short-stemmed femoral shaft prostheses have been introduced especially for younger patients. Some of these new procedures are still in development and long term results of new implant concepts have to be evaluated in the next one or two decades. Most probably not every modern concept will stand the test of time, but some of them will be beneficial for our patients undergoing total hip arthroplasty in the future.
Authors and Affiliations
Christoph Eingartner
Keywords
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