Both patients and surgeons should remember that a successful outcome after total hip arthroplasty is the result of both faultless surgical skills and properly designed implants. We should also have in mind that most importantly, patient engagement starting preoperatively and continuing on through the perioperative and rehabilitation process is fundamental in order to achieve patient satisfaction. This unique technique book about total hip arthroplasty covers all aspects of surgical reconstruction of the hip in adults. This comprehensive text focuses on primary, complex and conversion total hip arthroplasty. This text is not meant to be just a reference and didactic text. The book is intended to be used as a clinical and surgical guide with step-by-step explanations of the various procedures and conditions. It is a reference to be used while planning and preparing for both routine and less common surgical cases.

We envision surgeons and surgeons in training using the text for surgery planning and management of difficult hip reconstruction cases.

The book contains 18 chapters that are organized in a way that allows quick and easy access while preparing for a difficult and challenging case.

The emphasis of the text is on technique and may fall short on the amount of references cited, but each chapter is accompanied by many images, radiographs and illustrations that help highlight the important points and skills demonstrated. The authors of the various chapters were invited to contribute their knowledge and expertise in the field of hip arthroplasty. The authors were selected based on their interest and skill related to the specific surgical technique illustrated in their respective chapters. Each chapter includes a thorough background of the specific technique as well as indications, contraindications, possible pitfalls and complications, and treatment options including both non-surgical and surgical options. A step-by-step surgical technique is included in each chapter detailing and explaining the procedure in depth.

We hope this textbook will become a reference in the ever-expanding toolbox of the hip arthroplasty surgeon.

After experiencing many long days and evenings in the operating room, I came to recognize the remarkable training I received during my fellowship at Brigham and Women's Hospital in Boston. I would like to thank my teachers and mentors there, who patiently and skillfully taught me cutting edge total joint arthroplasty and revision surgery. Among which are Dr Estok, Dr Brick, Dr Ready, Dr Fitz, Dr Scott, and Dr Thornhill.

I am grateful to Ms Chetna Malhotra Vohra (Senior Manager–Business Development), Saima Rashid (Development Editor) and all the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India, for hard work and patience.

Last but not least, I would like to acknowledge my current colleagues at University of California, Irvine, who strongly support my work and passion.

Age followed an inverted U-shaped distribution (peak age 60s–70s) and higher rates were found for female gender. Postsecondary education, higher income, obesity, nonminority race/ethnicity, and rural residence were social structure factors associated with higher arthroplasty rates. The willingness of patients to consider surgery was associated with a more than 3-fold higher arthroplasty rate (health beliefs). Several studies evaluated the influence of insurance status on the likelihood of undergoing arthroplasty.^– The authors concluded that insurance coverage (personal resources) was a strong predictor of surgical treatment. Several community resources, such as surgeon supply, hospital volume, supply of operating rooms, and hospital costs, were associated with higher arthroplasty rates while supply of other physicians (including anesthesiologists) and regional hospital supply predicted lower surgical rates. While surgeon enthusiasm to recommend surgery was associated with higher knee arthroplasty rates, no studies looking at hip arthroplasty have been performed. A history of degenerative osteoarthritis and the presence of physical limitations were two factors of medical need both found to be associated with higher arthroplasty rates.

Regional variation in these procedures exists because they are examples of preference-sensitive care. With strategies that may affect change in factors that are potentially modifiable by behavior or resources, extreme variation in rates may be reduced.