La protesi d’anca: anything new?
Abstract
TOTAL HIP ARTHROPLASTY: ANYTHING NEW?
Total hip arthroplasty has been described as “the operation of the 20th century”, thanks to the great outcomes, patient
satisfaction and improvement in their quality of life. In the last years, changes have been introduced in terms of
surgical indications, approaches, tissue preservation, development of different implants, preoperative management
and postoperative protocols. The paper analyses different surgical approaches, in particular the anterior vs the
postero-lateral approaches; it focuses on surgical indications, either in younger or in older patients, as well as on
implants designs. Uncemented stems are frequently used in total hip arthroplasty; among these, short stems have
gained space in the market in selected patients. They allow for preservation of the femoral neck, producing a more
physiological load pattern in the proximal femur and reducing stress shielding. In short-term follow-up, most of the
short stems provided survival rates similar to standard stems; however, long-term studies are not yet available. The
aim of this review is to summarise the advances in hip arthroplasty, the current literature on surgical approaches,
stems design, biomechanical aspects and clinical outcomes associated mostly with the length of the femoral component
in primary hip replacement.
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Copyright
© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2019 , 2019
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