Abstract
Wear is the major reason of late failure of THA. Progressive osteolysis can produce loss of bone, implant failure, and difficulties in revision due to bone deficiency. This is the reason why the best “treatment” is to prevent failures related to articulation by employing low wear bearing surfaces and monitoring the patients. Troubles with materials teach that there is not an ideal solution for every case in THA and that the surgeon must select the proper tribology for each patient. The correct component position and orientation is critical for each coupling. A proper surgical technique and implant position remain crucial. Early revision improving the tribology can prevent catastrophic complications such as major bone loss or loosening. Major unnecessary surgery should be avoided and only the failed components should be revised. Malposition must be corrected. The center of rotation, off-set and bone stock should be restored whenever possible. Different options and how to face different situations in case of revision are analyzed in this paper.
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Zagra, L., Bianchi, L., Ceroni, R.G. (2012). How to Treat Failures Related to Articulation. In: Knahr, K. (eds) Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27361-2_2
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DOI: https://doi.org/10.1007/978-3-642-27361-2_2
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