Limb discrepancy causes patient dissatisfaction, pain, gait disturbance etc Postoperative goal is a final LLD of <1 cm Evaluate and document any structural and apparent limb-length discrepancy before total hip arthroplasty for later comparison Measurement of LLD on a preoperative anteroposterior pelvic radiograph is best performed using the inter-teardrop line and the femoral head center as the landmarks Hip position…
Dislocation is the cause of 15% of THA revision surgeries Surgeon factors : Component Positioning, Implant Choice, Surgical Approach Low-volume surgeons and patients with elevated BMI increase the risk of malpositioning No convincing evidence that fluoroscopic or robotic assistance helps Increasing the size of the femoral head (up to 38 mm) provides greater resistance to dislocation Dual-mobility designs also raise…
Bearing surfaces : Highly cross-linked polyethylene (XLPE) Ceramic-on-ceramic (COC) Metal-on-metal (MOM) Adaptive immune response appear to be more frequent and of greater magnitude in failed metal-on-metal implants CoC bearings had better survival than did MoM bearings at the ten-year follow-up For older, less active patients, traditional metal-on-polyethylene bearings are the appropriate choice MOM causes metallosis and local tissue pseudotumor formation…
