Total hip arthroplasty (THA) is one of the most common procedures performed in the United States and worldwide. Despite the high rate of success, there are reported complications that necessitate revision arthroplasty. These can be challenging cases, so in this current issue of Orthopedic Clinics of North America , we present two important topics: implant selection in revision THA and the management of the infected THA.
Critical to the success of revision THA is choosing the right implant. Component selection for revision THA is directed toward creating a stable hip, restoring appropriate leg lengths, and providing offset to optimize joint kinemanics. Multiple factors, described by Chen and Hozak, go into the decision-making process, including the mechanism of failure, the type of implant in situ, and femoral or acetabular bone loss. The utility of various implant choices should be clearly understood by those surgeons performing revision THA.
One of the more devastating complications is an infected THA. The appropriate diagnosis of a prosthetic hip infection is a critical first step to successful management and functional recovery of the patient. Konigsberg and coauthors report on the recent work by the Musculoskeletal Infection Society, which created a new uniform definition for both research and clinical use. It is imperative that orthopedic surgeons remain current in regard to recommendations for evaluation and diagnosis of prosthetic joint infection. Keeping up-to-date on the current evidence-based recommendations is an important part of the management of these complicated infections.
It is anticipated that the readers will find these two articles in the adult reconstruction section insightful and a resource for their clinical practice.