Recommendations for Maximizing Range of Motion
With the dawn of the new Millennium, Hip replacement surgery entered a new era of expanding indications and technological improvements which seek to further optimize one of the most successful interventions of modern medicine. In the beginning, there was the low friction arthroplasty. John Charnley recognized that synthetic materials did not have the very low wear demonstrated by articular cartilage. For that reason he moved away from the large ball heads that were part of normal human anatomy. Because his technique often resulted in a transposition of the greater trochanter, pain relief and stability along with a protected sedentary lifestyle were the keys to successful outcomes. He was a master at limiting patient expectations and reserving the procedure for the low demand elderly. The leg length discrepancies and other biomechanical alterations were much welcomed trade offs for the comfort and function improvements that were a result of hip replacement. It changed many people’s lives. However some 4 decades later, we are faced with a much different situation. Hip replacements are very successful and surprisingly durable. Hip disease in the younger and more active elderly is best treated with this procedure, as no other intervention is able to restore the comfort and function of these patients so reliably. In addition, trauma and osteonecrosis continue to afflict many younger individuals who need to work and raise families. Once again, hip replacement stands alone in its ability to restore comfort and function for the long term.
KeywordsVolumetric Wear Acetabular Anteversion Computer Assisted Surgery Ball Head Neck Geometry
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- 2.Callaghan, J; Preventing Dislocation: is a big head in your future; Current Concepts in Joint Replacement, Spring 2001.Google Scholar
- 4.Mckellop H, Lu B. Friction, lubrification, and wear of cobalt-chromium, alumina, and zirconia hip prostheses compared on a joint simulator. Proc. Orthopedic Research Society, Washington, D.C. 402, 1992.Google Scholar
- 6.Gustafson, A; Clarke I, “metalosis of ceramic-ceramic THR secondary to rim impingement”, Bioceramics in Joint Arthroplasty, edited by H. Zippel, M. Dietrich, Steinkopff Verlag, 2003.Google Scholar
- 7.Bader R. Steinhauser E. Gradinger R. Willmann G. Mittelmeier W. [Computer-based motion simulation of total hip prostheses with ceramic-on-ceramic wear couple. Analysis of implant design and orientation as influence parameters]. [German] [Journal Article] Zeitschrift für Orthopädie und Ihre Grenzgebiete. 140(3):310–6, 2002 May–Jun.PubMedCrossRefGoogle Scholar