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.

Keywords: Hip replacement; arthroplasty..

Fig. (1)

Schematic diagram showing parts of a standard femoral component for THA.

Fig. (2)

Schematic diagram showing acetabular coronal tilt and anteversion angles.

Fig. (3)

Schematic diagram showing the Joint Reaction Force generated by the abductor lever arm.

Fig. (4)

Schematic diagram showing the effect of head size on primary arc range.