Hip arthroplasty

Indications

Osteoarthritis or rheumatoid arthritis unresponsive to conservative or medical treatment, and causing pain and disability.

Causes

Youth
  1. Idiopathic
  2. Injury
  3. Perthes
  4. Congenital dislocation
Age
  1. 2° to RhA
  2. avascular necrosis
  3. Paget's disease

Treatment

Conservative

Medical

Surgical

NICE guidance

Only prostheses with revision rate 10% or less at 10 years. Most of the current evidence is for cemented prostheses. Less evidence for uncemented or hybrid prostheses.
Other criteria:
  1. Persistence of pain & immobility
  2. Ease of revision
Set up hip registry to monitor performance of different implants.