Total Hip Arthroplasty at the Rothman Institute

Abstract

Background Total hip arthroplasty (THA) is one of the most successful surgical interventions devised in modern times. Attempts to change the current THA procedure with unproven innovations bring the risk of increased failure rates while trying to improve the benefit of the surgery. Questions/Purposes This manuscript examines the evolution of THA at the Rothman Institute illustrating the key elements that lead the success of this procedure at this institution. These key elements include femoral stem design, use of highly crossed-linked polyethylene and use of pain and rehabilitation protocols. We attempted to describe the long-term results regarding safety, effectiveness, and durability of specific THA implant designs used at this institution drawing on reported evidence in the literature. Methods The authors performed a review of peer-reviewed articles related to the Rothman Institute's experience with THA. Results Total hip arthroplasty is an efficient, safe, and durable procedure. It is a highly successful operation to restore function and improve pain. The survivorship of THA procedures at the Rothman Institute is higher than 99% at 10 years based on mechanical failure. The use of collarless, tapered wedge femoral stem, highly crossed-linked polyethylene, and improved pain rehabilitation protocols have contributed to this success. Conclusions There is a well-documented long-term survivorship after THA. Future innovation in THA should address new challenges with younger and more demanding patients, rather than change current methods that have a proven good survivorship. This innovation depends mainly upon improvements in the bearing surfaces and advances in pain control and rehabilitation.

Research on the inhibition for aseptic loosening of artificial joints by Sr-doped calcium polyphosphate (SCPP) in vivo

“…However, when the normal or abnormal activity occurred between the polyethylene and adjacent metal or ceramic joint head surfaces, the polyethylene cup is the most vulnerable to be worn due to its softer characteristics. UHMWPE wear debris accounts for 70%-90% of the artificial joint prosthesis's total wear debris [1]. These wear debris are existed on the prosthetic joint surface, the bone-cement-metal surface, and the bone-metal surface, and these particles could enter the interface between bone and graft prosthesis with the synovial fluid, resulting in the osteolysis around prosthesis, which is a key factor for the aseptic loosening of the prosthesis.…”

Tripolar Constrained and Dual Mobility Liners Are Both Successful When Cemented Into Tantalum Acetabular Revision Shells in Complex Revision Total Hip Arthroplasty

“…Although total hip arthroplasty (THA) is extremely successful [ 1 , 2 ], dislocation remains a problem, with an incidence from 0.2% to 10% in primary THA and from 10% to 28% after revision THA (rTHA) [ 3 ]. Berry et al.…”

Templating Hip Arthroplasty

“…According to a review of peer-reviewed articles related to the experience of Rothman Institute, hip arthroplasty is a very safe, reliable and efficient procedure with a 10-year survival rate of the implant being greater than 99%. This remarkable rate of success has been attributed largely to the use of modern nonmetal implants [ 4 ]. Previously, metal on metal implants was used for hip joint replacement procedures, but their failure has been reported on numerous occasions [ 5 ].…”