One of the most popular and effective orthopedic surgical interventions for treating a variety of hip diseases is total hip arthroplasty. Despite being a radical procedure that involves replacing bone and cartilaginous surfaces with biomaterials, it produces excellent outcomes that significantly increase the patient’s quality of life. Patient factors and surgical technique, as well as biomaterials, play a role in prosthetic survival, with aseptic loosening (one of the most common causes of total hip arthroplasty failure) being linked to the quality of biomaterials utilized. Over the years, various biomaterials have been developed to limit the amount of wear particles generated over time by friction between the prosthetic head (metal alloys or ceramic) and the insert fixed in the acetabular component (polyethylene or ceramic). An ideal biomaterial must be biocompatible, have a low coefficient of friction, be corrosion resistant, and have great mechanical power. Comprehensive knowledge regarding what causes hip arthroplasty failure, as well as improvements in biomaterial quality and surgical technique, will influence the survivability of the prosthetic implant. The purpose of this article was to assess the benefits and drawbacks of various biomaterial and friction couples used in total hip arthroplasties by reviewing the scientific literature published over the last 10 years.

The present study describes a 29 years old patient diagnosed with aseptic osteonecrosis with multiple localization occurred after a corticoid treatment for chronic toxic hepatitis. The clinical and para-clinical examinations determined the diagnosis of Wilson disease and avascular necrosis with multiple localizations. The evolution of the disease was favourable following the surgical treatment consisting of bilateral total hip arthroplasty with cementless prosthesis, hemi-arthroplasty of the left shoulder with cementless prosthesis, orthotopic hepatic transplantation with an entire liver from donor in cerebral death and immunosuppressive, anticoagulant, antiretroviral and gastro-protective treatment. There is an increase of the number of patients undergoing a glucocorticoids treatment for several months, years or lifelong periods. This type of treatment increases the risk of osteonecrosis depending on the dosage and the duration of the treatment.

The change of the organic bone cements�composition (COO) determines the adjustment of some important properties for the behaviour as fixing material, such as the: superficial tension, polarity, surface energy, viscosity, contraction at polymerisation, porosity. In the present paper we monitored the influence of the composition�s changes for some acrylic cements upon their handling features. The samples were obtained via the partial replacement of the methyl methacrylate (MMA) in the liquid phase of some usual formulas with another acrylic monomer. For these, it was measured the contact angles as wettablility of the fixing material. Moreover, it was estimated the values of the hardening time, important parameter for the application phases of the cements with cold hardening and fixing of the articular endoprostheses.

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

Successfully used in bone surgery for more than 65 years, self-hardening organic cements (CCOs), in particular acrylic cements, are today, the most advanced complementary biomaterials used in articular endoprosthesis. One of the strategies for obtaining of performing anchorage of artificial implants is to develop new acrylic cements with improved physical, chemical and biomechanical characteristics. The aim of this paper was to identify the compositional and morpho-structural changes of acrylic cements induced by the composition of the liquid phase of the material. Such changes influence the potential to generate the physical bonds responsible for fixation and stabilization of endoprosthesis. The samples studied had different compositions due to the mixture of acrylic monomers, methyl methacrylate (MMA) and butyl acrylate (BuA) in the liquid component of cement. The MMA / BuA ratio varied between 1/0 v / v and 1/4 v / v. Changes in the composition and morphology of cement samples have been highlighted by ESCA (Electron Spectroscopy for Chemical Analysis), EDX (Energy-Dispersive X-ray Spectroscopy), IR spectroscopy and SEM images. The obtained data show that minor changes in cement composition can significantly influence morpho-structural characteristics such as pore size and their distribution in the mass of fixing material.