The outcome after total hip replacement has improved with the development of surgical techniques, better pain management and the introduction of enhanced recovery pathways. These pathways require a multidisciplinary team to manage pre-operative education, multimodal pain control and accelerated rehabilitation. The current economic climate and restricted budgets favour brief hospitalisation while minimising costs. This has put considerable pressure on hospitals to combine excellent results, early functional recovery and shorter admissions. In this review we present an evidence-based summary of some common interventions and methods, including pre-operative patient education, pre-emptive analgesia, local infiltration analgesia, pre-operative nutrition, the use of pulsed electromagnetic fields, peri-operative rehabilitation, wound dressings, different surgical techniques, minimally invasive surgery and fast-track joint replacement units.

The authors report a rare case of piriformis pyomyositis, in a teenage rugby player, who was initially feverish and presented to us with low back pain, sciatica and inability to mobilise due to pain. Subsequent imaging investigations (MRI scan) revealed abscess formation in the piriformis muscle with compression effect on the ipsilateral sciatic nerve. A course of intravenous antibiotic therapy followed by oral antibiotics fully resolved his symptoms and returned inflammatory markers back to normal.

Uncemented femoral stems have shown good, long-term survivorship and functional outcome, with promising results in younger patients.Limitations in the current literature make it difficult to assess and compare different designs to determine optimal indications for each type.Biological fixation, in which the prosthesis is directly fixed to the bone, is the preferred fixation method.Future studies of cementless implants should consistently address patient age, activity level, bone type, and deformities so that more definitive conclusions can be drawn about when to use each design.

We aim to explore the potential technologies for monitoring and assessment of patients undergoing arthroplasty by examining selected literature focusing on the technology currently available and reflecting on possible future development and application. The reviewed literature indicates a large variety of different hardware and software, widely available and used in a limited manner, to assess patients’ performance. There are extensive opportunities to enhance and integrate the systems which are already in existence to develop patient-specific pathways for rehabilitation. Cite this article: Bone Joint J 2022;104-B(10):1104–1109.