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Total hip replacement is a frequently done and highly successful surgical intervention. The procedure is undertaken to relieve pain and improve function in individuals with advanced arthritis of the hip joint. Symptomatic osteoarthritis is the most common indication for surgery. In paper 1 of this Series, we focus on how patient factors should inform the surgical decision-making process. Substantial demands are placed upon modern implants, because patients expect to remain active for longer. We discuss the advances made in implant performance and the developments in perioperative practice that have reduced complications. Assessment of surgery outcomes should include patient-reported outcome measures and implant survival rates that are based on data from joint replacement registries. The high-profile failure of some widely used metal-on-metal prostheses has shown the shortcomings of the existing regulatory framework. We consider how proposed changes to the regulatory framework could influence safety.

Original publication

DOI

10.1016/S0140-6736(18)31777-X

Type

Journal article

Journal

Lancet

Publication Date

03/11/2018

Volume

392

Pages

1662 - 1671

Keywords

Arthroplasty, Replacement, Hip, Benchmarking, Decision Making, Hip Prosthesis, Humans, Osteoarthritis, Hip, Outcome Assessment (Health Care), Postoperative Complications, Prosthesis Design, Prosthesis Failure, Reoperation