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Total hip arthroplasty

Authors
Greg A Erens, MD
Thomas S Thornhill, MD
Jeffrey N Katz, MD, MSc
Section Editor
Daniel E Furst, MD
Deputy Editor
Monica Ramirez Curtis, MD, MPH

INTRODUCTION

Total hip arthroplasty (THA) is one of the most successful orthopedic procedures performed today. For patients with hip pain due to a variety of conditions, THA can relieve pain, can restore function, and can improve quality of life. Sir John Charnley, a British orthopedic surgeon, developed the fundamental principles of the artificial hip and is credited as the father of THA. He designed a hip prosthesis in the mid to late 1960s that still sees use today. It is estimated that over 300,000 total hip arthroplasties are performed each year in the United States alone [1].

The normal hip functions as a “ball-and-socket” joint. The femoral head (ball) articulates with the acetabulum (socket), allowing smooth range of motion in multiple planes. Any condition that affects either of these structures can lead to deterioration of the joint. This, in turn, can lead to deformity, pain, and loss of function. The most common condition affecting the hip in this way is osteoarthritis. Other conditions that may affect the hip adversely include inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, spondyloarthropathies, etc), developmental dysplasia, childhood hip disorders (Legg-Calve-Perthes disease, slipped capital femoral epiphysis, etc), trauma, neoplasms, and osteonecrosis. (See appropriate topic reviews.)

THA is a procedure whereby the diseased articular surfaces are replaced with synthetic materials, thus relieving pain and improving joint kinematics and function. Preoperative and operative issues related to THA are discussed in this topic review. Intraoperative and postoperative complications of THA are listed briefly below (see 'Complications' below) and are presented in more detail separately. (See "Complications of total hip arthroplasty".)

THA is an elective procedure and should be considered as an option among other alternatives. The decision to proceed with THA is made with an understanding of the potential risks and benefits. A thorough understanding of both the procedure and the anticipated outcome is an important part of the decision-making process. For the appropriate candidate, THA can be a life-altering procedure that relieves pain, improves function, and enhances quality of life.

OUTCOMES

Published results of total hip arthroplasty (THA) demonstrate excellent clinical, functional, and radiographic results. These results vary depending upon the implant, the surgical technique, the type of fixation, the biomaterials, the patient’s age, and a myriad of other factors. THA may be performed successfully in patients ranging from the very young [2-4] to older adults (over 80 years of age) [5]. However, young and active patients must be made aware that premature failure of the replaced joint may occur if activity levels are not reduced [2,3]. Impact activities, manual labor, heavy lifting, and high-intensity sports should be avoided.

                                         

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Literature review current through: Nov 2016. | This topic last updated: Fri Oct 23 00:00:00 GMT 2015.
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