Basic Science Considerations in Primary Total Hip Replacement Arthroplasty

Abstract

Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement.

Advanced biomaterials in hip joint arthroplasty. A review on polymer and ceramics composites as alternative bearings

“…The stability of this structure is obtained by the bony configuration combined with a complex system of muscles and ligaments around the joint [2].…”

Total hip arthroplasty using a combined anterior and posterior approach via a lateral incision in patients with ankylosed hips

“…Total hip arthroplasty (THA) has become the most common surgical procedure performed in developed nations. 2,3 Good outcomes are reported following THA in patients with ankylosed hips; 4 however, the procedure is technically demanding, and postoperative complications are not uncommon, particularly when compared with primary THAs. 5 Common approaches to the nonankylosed hip include the anterior, posterior and lateral approaches.…”

“…We defined blood loss as the volume of intraoperative suction plus the change in weight of the sponges used (postoperative sponge weight -preoperative sponge weight), with the sum divided by the density of blood (1.055 g/cm 3 ). Postoperative blood loss through drainage was not included.…”

Reflections on the Ethics of Biomaterials Science

“…Hip replacement involves an operation known as total hip arthroplasty (Mirza et al 2010) and uses a system comprising an artificial femoral component, the socalled femoral pin, which has a polished metal head smaller in diameter than the head of the natural femur. This part is now typically made of a titanium alloy, because titanium has been found to be extremely biocompatible inside the body (Long and Rack 1989).…”