Total Hip Arthroplasty at the Rothman Institute
- 199 Downloads
Total hip arthroplasty (THA) is one of the most successful surgical interventions devised in modern times. Attempts to change the current THA procedure with unproven innovations bring the risk of increased failure rates while trying to improve the benefit of the surgery.
This manuscript examines the evolution of THA at the Rothman Institute illustrating the key elements that lead the success of this procedure at this institution. These key elements include femoral stem design, use of highly crossed-linked polyethylene and use of pain and rehabilitation protocols. We attempted to describe the long-term results regarding safety, effectiveness, and durability of specific THA implant designs used at this institution drawing on reported evidence in the literature.
The authors performed a review of peer-reviewed articles related to the Rothman Institute’s experience with THA.
Total hip arthroplasty is an efficient, safe, and durable procedure. It is a highly successful operation to restore function and improve pain. The survivorship of THA procedures at the Rothman Institute is higher than 99% at 10 years based on mechanical failure. The use of collarless, tapered wedge femoral stem, highly crossed-linked polyethylene, and improved pain rehabilitation protocols have contributed to this success.
There is a well-documented long-term survivorship after THA. Future innovation in THA should address new challenges with younger and more demanding patients, rather than change current methods that have a proven good survivorship. This innovation depends mainly upon improvements in the bearing surfaces and advances in pain control and rehabilitation.
KeywordsTotal Hip Arthroplasty
(MSA) certifies that he has or may receive payments or benefits from a commercial entity (Zimmer) related to this work. (RHR) certifies that he has or may receive payments or benefits from a commercial entity (Stryker, Riverside) related to this work. One or more of the authors (MSA) has received research funding (DePuy). CAH certifies that he has no conflict of interest.
- 1.Bitsch RG, Loidolt T, Heisel C, Ball S, Schmalzried TP (2008) Reduction of osteolysis with use of Marathon cross-linked polyethylene. A concise follow-up, at a minimum of five years, of a previous report. The Journal of Bone and Joint Surgery. American Volume 90:1487–1491.PubMedCrossRefGoogle Scholar
- 7.Engh CA, Powers CC, Ho H, Beykirch-Padgett SE, Hopper RH, Jr., Engh CA, Jr. The effect of poly sterilization on wear, osteolysis and survivorship of a press-fit cup at 10-year followup. Clinical Orthopaedics and Related Research. 2011.Google Scholar
- 11.Hozack WJ, Rothman RH, Booth RE, Jr., Balderston RA. Cemented versus cementless total hip arthroplasty. A comparative study of equivalent patient populations. Clinical Orthopaedics and Related Research. 1993:161–165.Google Scholar
- 13.Hozack WJ, Rothman RH, Eng K, Mesa J. Primary cementless hip arthroplasty with a titanium plasma sprayed prosthesis. Clinical Orthopaedics and Related Research. 1996:217–225.Google Scholar
- 20.National Institute of Health. Consensus Statement Total Hip Replacement. 1994;12(5). http://consensus.nih.gov/cons/098/098_intro.htm. Accessed 8th August 2011.
- 21.National Joint Registry for England and Wales. 6th Annual Report. 2009. http://www.njrcentre.org.uk/NjrCentre/Portals/0/Sixth%20annual%20NJR%20report.pdf. Accessed 8th August 2011
- 26.Parvizi J, Wickstrom E, Zeiger AR, Adams CS, Shapiro IM, Purtill JJ, Sharkey PF, Hozack WJ, Rothman RH, Hickok NJ. Frank Stinchfield Award. Titanium surface with biologic activity against infection. Clinical Orthopaedics and Related Research. 2004:33–38.Google Scholar
- 31.Rothman RH. Accelerated Rehabilitation for Total Hip Arthroplasty. In: The Hip Society. Washington, D.C.: 2005.Google Scholar
- 32.Rothman RHS, P.F.; Hozack, W.J.; Martell, J. Wear performance of conventional (Arcom) and highly cross-linked acetabular liners in bilateral total hip arthroplasty. The Journal of Arthroplasty. 2004;19:261.Google Scholar
- 33.Sakalkale DP, Eng K, Hozack WJ, Rothman RH. Minimum 10-year results of a tapered cementless hip replacement. Clinical Orthopaedics and Related Research. 1999:138–144.Google Scholar