Primary total hip arthroplasty

Craig J. Della Valle, Daniel J. Berry, Charles R. Bragdon, John J. Callaghan, Rocco D’Apolito, Douglas A. Dennis, Ivan De Martino, Roger H. Emerson, Andrew A. Freiberg, Young Min Kwon, Kyle W. Lacy, Steven J. MacDonald, R. Michael Meneghini, Matthew C. Morrey, Bernard F. Morrey, Amar Ranawat, Harry E. Rubash, Thomas P. Sculco

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The results of total hip arthroplasty continue to improve over time, and with careful study of component performance, more data are available to help guide decision making. Although noncemented stem fixation has become more common and proved to have superior results in many patient populations, there is still a role for cemented femoral fixation in older patient groups. However, noncemented stem length has recently been debated, and the optimal length for a noncemented stem is unclear given that some short-stemmed designs are associated with excellent results. On the acetabular side, modular noncemented cups are used most frequently with excellent reported results; however, cemented cups may still have a role in certain populations, particularly because cost containment is increasingly focused on. Although a metal or ceramic femoral head articulating with a highly cross-linked polyethylene liner seems to perform best in most situations, the ideal femoral head size is still unclear and a topic of controversy. Larger femoral head sizes have been associated with a lower risk of dislocation and are used far more commonly in contemporary practice; however, they have their own risks and potential complications. Dual-mobility bearings are a unique, appealing solution for primary or revision total hip arthroplasties in which the patient is considered to be at high risk for dislocation. However, far less is known regarding their midterm and longer term performance, and appropriate caution should be exercised when choosing this bearing option.

Original languageEnglish (US)
Title of host publicationOrthopaedic Knowledge Update
Subtitle of host publicationHip and Knee Reconstruction 5
PublisherWolters Kluwer Health
Pages377-392
Number of pages16
ISBN (Electronic)9781975123819
ISBN (Print)9781975123796
StatePublished - Jan 1 2018

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Keywords

  • Acetabular component
  • Dual mobility
  • Femoral head size
  • Femoral stems
  • Primary total hip arthroplasty

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Della Valle, C. J., Berry, D. J., Bragdon, C. R., Callaghan, J. J., D’Apolito, R., Dennis, D. A., De Martino, I., Emerson, R. H., Freiberg, A. A., Kwon, Y. M., Lacy, K. W., MacDonald, S. J., Michael Meneghini, R., Morrey, M. C., Morrey, B. F., Ranawat, A., Rubash, H. E., & Sculco, T. P. (2018). Primary total hip arthroplasty. In Orthopaedic Knowledge Update: Hip and Knee Reconstruction 5 (pp. 377-392). Wolters Kluwer Health.