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Chapter-343 Total Hip Arthroplasty

BOOK TITLE: Textbook of Orthopedics & Trauma (4 Volumes)

Author
1. Shyam Ashok K
2. Jhunjhunwala HR
3. Suryanarayan P
4. Shah Vikram I
5. Pachore Javahir A
6. Vaidya Shrinand V
7. Deshmane Prashant P
8. Marimuthu Kanniraj
9. Dudani Baldev
10. Arora Pankush
11. Veigus Arjun
ISBN
9789385891052
DOI
10.5005/jp/books/12869_344
Edition
3/e
Publishing Year
2016
Pages
73
Author Affiliations
1. Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India, The Arthritis Clinic, Mumbai, Sancheti Institute for Orthopedics and Rehabilitation, Pune; Indian Orthopedic Research Group, Thane, Maharashtra, India; Indian Orthopedics Research Society; Journal of Orthopaedic Case Reports
2. D/4, Sunita 62, Pedder Road, Mumbai, Maharashtra, Postgraduate Institute of Medical Sciences, Bombay Hospital, Mumbai, Maharashtra, India, D/4, Sunita 62, Pedder Road, Mumbai, Maharashtra, India
3. Apollo Hospitals, Chennai, Tamil Nadu, India, Plough Share, 4/A, 415 Sitladevi Temple Road, Mahim (W), Mumbai, Maharashtra, India
4. Shalby Hospitals, Ahmedabad, Gujarat, India
5. Plough Share, 4/A, 415 Sitladevi Temple Road, Mahim (W), Mumbai, Maharashtra, India
6. Plough Share, 4/A, 415 Sitladevi Temple Road, Mahim (W), Mumbai, Maharashtra, India
7. Plough Share, 4/A, 415 Sitladevi Temple Road, Mahim (W), Mumbai, Maharashtra, India
8. Apollo Hospitals, Chennai, Tamil Nadu, India, SIMS Hospital, Institute of Orthopedics, Chennai, Tamil Nadu, India
9. Ruby Hall Clinic, Pune, Maharashtra, India
10. Sancheti Institute of Orthopedics and Rehabilitation, Pune, Indian Orthopedic Research Group, Thane, Maharashtra, India
11. Inlaks and Budhrani Hospital, Pune, Maharashtra, India
Chapter keywords
Total hip arthroplasty, cemented hip arthroplasty, total joint replacement, ankylosing spondylitis, acetabular fracture, porous-coated surface, bipolar hip arthroplasty, avascular necrosis

Abstract

Total hip replacement was introduced as a panacea to relieve the intractable pain of hip arthritis. This chapter discusses on the cemented hip arthroplasty, an overview of uncemented total hip arthroplasty and recent advances, revision total hip arthroplasty and bipolar hip arthroplasty. The main aims of total hip replacement surgery are pain relief, good functional mobility, stable joint, and if possible, correction of limb length. Poor preparation of femoral canal, over-reaming and removing cancellous bone, varus position of the femoral stem and poor cementing are the cause of the femoral loosening in a cemented hip arthroplasty. Cemented or cementless fixation are the two methods of long-term fixation of the hip. Component design, alignments, soft-tissue tension and soft-tissue functions are the four major areas of hip stability. Proper positioning of the components and good soft-tissue repair is the key to the success of total hip arthroplasties. Revision hip arthroplasty is one of the technically demanding aspects of hip arthroplasty surgery and for good outcomes several variables are to be considered including causes for failure of the primary procedure, infection, bone loss, implants available, technical expertise of the surgeon. Bipolar hip arthroplasty using a large acetabular cup for avascular necrosis hip has a low incidence of groin pain, acetabular erosion, and revision in midterm follow-up. Also as the integrity of the acetabulum is maintained the revision will be much easier than a revision of THA.

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