Key Points Precision of component placement and biomechanical reconstruction of total hip arthroplasty (THA) is one of THA's weak links. Successful THA depends on proper positioning of components. Computer navigation helps achieve an accurate cup position and reduces human error,…
Key Points Ceramic-on-ceramic bearings in total hip arthroplasty were first implemented as a solution to wear debris and subsequent osteolysis seen in traditional bearing surfaces. Ceramics are hard, scratch resistant, wear resistant, low friction, thermodynamically stable, chemically inert, biocompatible, and…
Key Points Highly cross-linked polyethylene (HCLPE) has demonstrated wear rate reduction of between 40% and 95% over conventional polyethylene. Current evidence in the literature does not reveal significant rates of osteolysis or autoimmune reaction to HCLPE. Long-term studies have not…
Key Points Metaphyseal fit and ingrowth can provide both rotational and axial stability without distal diaphyseal support. Bone remodeling after insertion of metaphyseal engaging short stems shows endosteal condensation and cortical hypertrophy in the proximal metaphyseal region of the femur.…
Key Points Single-taper stems are tapered in the medial/lateral (ML) plane but are flat in the anteroposterior (AP) plane, appearing as a rectangle on a lateral radiograph. Double-taper stems maintain the ML taper design but taper in the AP plane…
Key Points Uncemented tapered femoral components have shown predictable and durable results in primary total hip arthroplasty. There are subtle differences in the inherent design of and surgical technique recommended for the various tapered cementless stems available in the current…
Key Points Uncemented extensively porous-coated femoral components have a 98% stem survival rate at 20 years. The implant can be used for all diagnoses and in all qualities of bone. Defining characteristics of the stem include its nontapered cylindrical distal…
Key Points Indication: cemented stems ( Fig. 65.1 ) are indicated in patients in all age groups who require a hip arthroplasty for any pathology ( Fig. 65.2 ). Results from national joint registries confirm that cemented taper-slip femoral components…
Key Points Requirements for cementless ingrowth include initial implant stability, appropriate pore size, adequate surface contact with host bone, and an implant material that is conducive to bone ingrowth. Titanium has been shown to be qualitatively and quantitatively superior to…
Key Points Cemented total hip replacement (THR) continues to be a commonly performed technique in arthroplasty. The cemented acetabular component is often considered the “weak link” in the longevity of a fully cemented THR. Each patient should undergo assessment and…