Total Hip Arthroplasty: Past, Present, and Future. What Has Been Achieved?

Abstract

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA. In this review, we focus on the evolution of THA and review current controversies and future directions of this procedure based on a single surgeon's 29-year of experience at a single institution.

Preoperative meloxicam versus postoperative meloxicam for pain control, patients’ satisfaction and function recovery in hip osteoarthritis patients who receive total hip arthroplasty: a randomized, controlled study

“…Therapeutic modalities for hip OA patients include physical exercise, weight management, non-steroidal anti-inflammatory drugs (NSAIDs) or other analgesics, sodium hyaluronate injection and surgery (Migliore and Anichini 2017 ; Murphy et al 2016 ; Skou and Roos 2019 ). Among all the treatment options mentioned above, total hip arthroplasty (THA) surgery is the gold standard for hip OA patients with severe disease conditions with satisfactory efficacy in improving the function of hip joint (Shon et al 2019 ).…”

Historical overview of hip arthroplasty: From humble beginnings to a high-tech future

“…30 Also, hip designs and manufacturers should acknowledge that certain populations and cultures may need a more personalized implant, accustomed with their life-style, especially in Asia. 31 In the last years, hip arthroplasty became less invasive, with better materials, more resistant to wear and more biocompatible and the prevention of complications and perioperative management is greatly improving together with advances in pain control, anesthesia and rehabilitation. Quoting Prof. Luigi Zagra, 32 advances in hip arthroplasty "should be based on changes which are safe with well proven advantages for the patient, with a wise progressive introduction of the novelties in the clinical trials.…”

“… 30 Also, hip designs and manufacturers should acknowledge that certain populations and cultures may need a more personalized implant, accustomed with their life-style, especially in Asia. 31 …”

Fibroblast-Like-Synoviocytes Mediate Secretion of Pro-Inflammatory Cytokines via ERK and JNK MAPKs in Ti-Particle-Induced Osteolysis

“…Degenerative skeletal diseases such as osteoarthritis, rheumatoid arthritis, and osteoporosis lead to skeletal disabilities and often require total joint arthroplasty (TJA) to provide restoration of function and pain relief. TJA is an overwhelming successful surgical intervention of modern medicine that is a remarkably effective and safe method of treatment [ 1 , 2 ]. Annually, millions of people (>1.3 million) undergo TJA [ 3 ].…”