Interfaces in Total Hip Arthroplasty

  • Ian D. Learmonth

Table of contents

  1. Front Matter
    Pages i-xii
  2. Component-Cement Interface

  3. Cement-Bone Interface

    1. Front Matter
      Pages 31-31
    2. H. G. Willert, G. H. Buchhorn
      Pages 33-43
    3. A. McCaskie
      Pages 45-55
  4. Modular Interface

    1. Front Matter
      Pages 57-57
  5. Component-Bone Interface

    1. Front Matter
      Pages 69-69
    2. J. D. J. Eldridge, I. D. Learmonth
      Pages 71-80
  6. Articular Interface

    1. Front Matter
      Pages 103-103
    2. J. E. Parr, W. Haggard, H. H. Trieu
      Pages 105-112
    3. J. L. Tipper, A. A. Besong, H. Minakawa, M. H. Stone, B. M. Wroblewski, E. Ingham et al.
      Pages 113-120
    4. P. Roberts, P. Grigoris
      Pages 121-133
    5. L. Sedel
      Pages 135-141
    6. J. Witvoet, R. Nizard, L. Sedel
      Pages 143-150
  7. Infected Interface

  8. Back Matter
    Pages 163-168

About this book


This book incorporates the experience of numerous experts who explore contemporary opinion of how best to rationalise and optimise the interfaces at total hip replacement to provide the most favourable and durable results. The survival of a total hip replacement depends principally on the enduring integrity of the fixation interfaces and of the articular interface. The design of the stem and the material properties of cement largely determine the state of the component-cement inter­ face, while the bone-cement interface is significantly influenced by both mechanical and biological factors. The surface finish and shape of cementless implants are designed to preserve the integrity of biological fixation (osseo-integration) at the bone-component interface. Once again, both mechanical and biological factors have to be considered, while bioactive coatings accelerate bone ongrowth. Metal-on-polyethylene is the most widely used articular interface. However, it has been suggested that wear of polyethylene is one of the major factors contributing to failure of total hip replacements. The increasing prevalence of total hip replacement in younger patients has stimulated the investigation of alternative, more durable couples -including ceramic-polyethylene, ceramic-ceramic and metal-on-metal. Modularity provides greater intra-operative flexibility, but each new modular interface introduces new mechanisms of failure. These need to be anticipated and appropriate measures taken to avoid them. Hopefully this book will provide a better understanding of the factors that contribute to stable interfaces and long-term survival of total hip arthroplasty.


Interface Mechanics arthroplasty bone fixation hip hip arthroplasty implant orthopaedic surgery pain surgery

Editors and affiliations

  • Ian D. Learmonth
    • 1
    • 2
  1. 1.Department of Orthopaedic SurgeryUniversity of BristolUK
  2. 2.Bristol Royal Infirmary and Southmead HospitalUK

Bibliographic information