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Plastic Surgery90 papers

Arthritis of hip

Last edited: 3 h ago

Overview

Arthritis of the hip, primarily osteoarthritis (OA), is a degenerative joint disease characterized by the breakdown of articular cartilage, leading to pain, stiffness, and reduced mobility. This condition significantly impacts quality of life, particularly in older adults and those with previous hip injuries. Total hip arthroplasty (THA) is a highly effective surgical intervention that can dramatically improve pain relief, functional capacity, and overall well-being for patients suffering from end-stage hip arthritis. Given the aging global population and increasing prevalence of hip disorders, THA is becoming increasingly common, underscoring its clinical significance in modern orthopedic practice. Understanding optimal surgical techniques, patient selection, and postoperative management is crucial for maximizing outcomes and minimizing complications in day-to-day clinical practice. 1 3 5 10

Pathophysiology

Arthritis of the hip, predominantly osteoarthritis, evolves through a complex interplay of mechanical stress and biological responses. Initially, repetitive microtrauma and biomechanical alterations lead to cartilage degradation, characterized by loss of proteoglycans and collagen fibers. This degradation exposes subchondral bone, initiating an inflammatory cascade involving cytokines and chemokines such as interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-α). These inflammatory mediators recruit macrophages and synovial cells, further exacerbating cartilage breakdown and bone remodeling. Over time, osteophytes form as a compensatory mechanism, but they often contribute to joint stiffness and pain. Additionally, subchondral bone sclerosis and cyst formation can occur, complicating joint mechanics and contributing to the progressive functional decline observed in patients. 4 7

Epidemiology

The incidence of hip arthritis, particularly osteoarthritis, is rising due to demographic shifts towards an aging population. Globally, the prevalence of symptomatic hip OA is estimated to affect millions, with significant regional variations. In high-income countries like the United States and Canada, the number of hip arthroplasties performed annually is projected to more than double over the next two decades, reflecting both population aging and increased surgical intervention rates. THA is predominantly performed in patients aged 50 years and older, with a slight female predominance. Geographic variations exist, with higher rates of THA in regions with advanced healthcare systems and higher elderly populations. Risk factors include advanced age, obesity, previous hip injury, and genetic predispositions. Trends indicate a growing trend towards earlier surgical intervention for severe cases, driven by improved surgical techniques and patient demand for better quality of life. 1 3 8 9

Clinical Presentation

Patients with hip arthritis typically present with chronic hip pain, often worse with weight-bearing activities and at night. Pain may radiate to the groin, thigh, or knee, and patients often report stiffness, particularly in the morning or after periods of inactivity. Functional limitations become evident as the disease progresses, with difficulty in walking, climbing stairs, and performing daily activities. Red-flag symptoms include unexplained weight loss, fever, and acute onset of symptoms, which may suggest infection or other serious underlying conditions requiring urgent evaluation. Physical examination reveals restricted range of motion, crepitus, and tenderness over the joint. Radiographic findings, such as joint space narrowing, osteophyte formation, and subchondral sclerosis, are crucial for confirming the diagnosis and assessing disease severity. 1 4 11

Diagnosis

The diagnosis of hip arthritis typically involves a combination of clinical assessment and imaging studies. Diagnostic Approach:

Clinical Evaluation: Detailed history and physical examination focusing on pain patterns, functional limitations, and signs of inflammation.

Imaging: Radiography is often the initial imaging modality, showing characteristic changes like joint space narrowing, osteophytes, and subchondral sclerosis. Advanced imaging such as MRI or CT may be necessary for complex cases or to rule out other pathologies.

Specific Criteria and Tests:

Radiographic Criteria:

- Joint space narrowing (≥50% reduction in joint space width) - Presence of osteophytes - Subchondral sclerosis or cysts

Imaging Modalities:

- X-ray: Essential initial imaging - MRI: For detailed soft tissue assessment (if needed) - CT: For bony detail and complex fractures (if needed)

Differential Diagnosis:

- Rheumatoid Arthritis: Typically presents with symmetrical joint involvement and systemic symptoms - Avascular Necrosis: History of trauma or corticosteroid use; MRI can differentiate - Hip Fractures: Acute onset of pain, localized tenderness, and abnormal mobility - Infection: Fever, elevated inflammatory markers, and systemic symptoms 1 4 11

Management

Non-Surgical Management

First-Line Approach:

Pharmacotherapy:

- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): For pain relief and inflammation (e.g., ibuprofen 400-800 mg TID, max 1200 mg/day) - Acetaminophen: For pain control (e.g., paracetamol 500-1000 mg QID) - Glucosamine and Chondroitin: Limited evidence but may provide modest benefit (e.g., glucosamine 1500 mg/day, chondroitin 1200 mg/day)

Physical Therapy:

- Strengthening Exercises: Focus on hip abductors, quadriceps, and gluteal muscles - Range of Motion Exercises: To maintain mobility and reduce stiffness - Weight Management: Reducing load on the hip joint

Second-Line Approach:

Intra-articular Injections:

- Corticosteroids: For short-term pain relief (e.g., triamcinolone 40 mg/mL, 2-4 mL per joint) - Hyaluronic Acid: May provide symptomatic relief in some patients (e.g., 20-30 mg/mL, 2-3 mL per joint)

Assistive Devices:

- Canes or Walkers: To reduce load and improve mobility

Surgical Management

Primary Intervention:

Total Hip Arthroplasty (THA):

- Surgical Techniques: - Cemented vs. Uncemented Stems: Choice based on patient factors (e.g., younger patients may benefit from uncemented stems due to better bone ingrowth) - Approaches: Direct Anterior (DAA) or Posterior (PA) approaches, with outcomes generally comparable in terms of functional and radiographic outcomes 11 - Bearings: - Ceramic on Highly Cross-Linked Polyethylene (HXLPE): Known for reduced wear rates and improved longevity - Postoperative Care: - Early Mobilization: Encouraged to prevent complications like deep vein thrombosis (DVT) and pneumonia - Physical Therapy: Initiated early to restore function and mobility

Contraindications:

Severe systemic illness precluding surgery

Active infection

Severe osteoporosis with high risk of periprosthetic fractures

Complications

Acute Complications:

Infection: Risk factors include perioperative contamination, prolonged surgery time, and immunocompromised states

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Prophylactic anticoagulation recommended

Periprosthetic Fractures: Particularly in osteoporotic patients

Dislocation: More common in posterior approach; early mobilization protocols help reduce risk

Long-Term Complications:

Implant Loosening and Wear: Regular follow-up with radiographs to monitor

Stiffness and Reduced Range of Motion: Often managed with physical therapy

Squeaking Noises: Common with ceramic bearings; generally benign but may require revision in severe cases 7 12

Prognosis & Follow-Up

The prognosis for patients undergoing THA is generally favorable, with significant improvements in pain relief and functional capacity. Key prognostic indicators include preoperative functional status, patient age, and the presence of comorbidities such as sarcopenia. Follow-Up Recommendations:

Immediate Postoperative: Regular monitoring for complications (e.g., DVT, infection)

Short-Term (3-6 Months): Assess functional recovery and address any early complications

Long-Term (Annually): Radiographic evaluation to monitor implant stability and wear; clinical assessment for signs of loosening or infection

Special Populations

Elderly Patients

Considerations: Increased risk of comorbidities, slower recovery; careful patient selection and tailored rehabilitation plans are essential.

Management: Emphasis on minimally invasive techniques and fast-track protocols to reduce hospital stay and improve outcomes. 10

Sarcopenic Patients

Risk Factors: Higher postoperative complications, poorer functional recovery.

Interventions: Preoperative nutritional support, targeted muscle strengthening programs, and close postoperative monitoring. 4

Pediatric and Adolescent Patients

Rarity: THA in teenagers is uncommon due to concerns over growth plate disturbances and future revision needs.

Indications: Severe, debilitating arthritis unresponsive to conservative treatments.

Management: Conservative options prioritized initially; surgical intervention reserved for severe cases with multidisciplinary evaluation. 6

Key Recommendations

Patient Selection for THA: Carefully evaluate preoperative functional status and comorbidities to predict postoperative outcomes (Evidence: Moderate) 4 1

Surgical Technique: Choose cemented or uncemented stems based on patient-specific factors such as age and bone quality (Evidence: Moderate) 1 5

Implant Choice: Utilize ceramic-on-highly crosslinked polyethylene bearings to minimize wear and improve longevity (Evidence: Strong) 7

Postoperative Mobilization: Implement early mobilization protocols to enhance recovery and reduce complications (Evidence: Strong) 10

Physical Therapy: Initiate comprehensive rehabilitation programs early to restore function and mobility (Evidence: Moderate) 1 3

Blood Management Strategies: Employ patient blood management protocols to minimize allogeneic blood transfusions (Evidence: Moderate) 8

Monitoring for Complications: Regular follow-up with radiographic assessments to monitor implant stability and wear (Evidence: Strong) 7

Consider Integrated Care Systems: Leverage coordinated care models to improve patient outcomes and satisfaction (Evidence: Moderate) 9

Evaluate Sarcopenia Preoperatively: Assess and manage sarcopenic status to mitigate postoperative risks (Evidence: Moderate) 4

Use of Digital Health Apps: Consider patient acceptability studies before implementing mHealth apps to enhance patient engagement and outcomes (Evidence: Weak) 3

References

1 Souza BGSE, Lacerda ID, Vasconcelos MM, Furtado NL, Vieira JM, Souza ISF et al.. Comparison of Uncemented and Hybrid Hip Arthroplasty: Protocol for a Brazilian Randomized Controlled Trial. JMIR research protocols 2026. link 2 Gharjare A, Deshmukh M. Pulsed electromagnetic field therapy versus sham therapy as an adjunct to conventional physiotherapy on pain, functional disability, and quality of life in patients undergoing total hip arthroplasty: a randomized placebo controlled trial protocol. Trials 2026. link 3 Louni Y, Laroche M, Alnasser A, Abuhaneya M, Belzile E, Baskaran S et al.. Acceptability of a Digital Care App in Patients Undergoing Hip and Knee Arthroplasty: Prospective Cohort Study. JMIR human factors 2026. link 4 Tanaka S, Kayamoto A, Terai C, Nojiri S, Fugane Y, Mori T et al.. Preoperative Sarcopenia Severity and Clinical Outcomes after Total Hip Arthroplasty. Nutrients 2024. link 5 Doyle TR, Davey MS, Toale JP, O'Driscoll C, Murphy CG. Simultaneous bilateral total hip arthroplasty-a survey of Irish orthopaedic surgeons' practice. Irish journal of medical science 2024. link 6 Te Velde JP, Buijs GS, Schafroth MU, Saouti R, Kerkhoffs GMMJ, Kievit AJ. Total Hip Arthroplasty in Teenagers: A Systematic Literature Review. Journal of pediatric orthopedics 2024. link 7 Weishorn J, Heid S, Bruckner T, Merle C, Renkawitz T, Innmann MM. How is hip anatomy reconstruction and inlay wear associated up to 10 years after primary THA using ceramic on highly crosslinked polyethylene bearings?. BMC musculoskeletal disorders 2023. link 8 Tripković B, Jakovina Blažeković S, Bratić V, Tripković M. CONTEMPORARY RECOMMENDATIONS ON PATIENT BLOOD MANAGEMENT IN JOINT ARTHROPLASTY. Acta clinica Croatica 2022. link 9 Agerholm J, Teni FS, Sundbye J, Rolfson O, Burström K. Patient-reported outcomes among patients undergoing total hip replacement in an integrated care system and in a standard care system in Region Stockholm, Sweden. BMC health services research 2022. link 10 Götz JS, Leiss F, Maderbacher G, Meyer M, Reinhard J, Zeman F et al.. Implementing fast-track in total hip arthroplasty: rapid mobilization with low need for pain medication and low pain values : Retrospective analysis of 102 consecutive patients. Zeitschrift fur Rheumatologie 2022. link 11 Nambiar M, Cheng TE, Onggo JR, Maingard J, Troupis J, Pope A et al.. No Difference in Functional, Radiographic, and Survivorship Outcomes Between Direct Anterior or Posterior Approach THA: 5-Year Results of a Randomized Trial. Clinical orthopaedics and related research 2021. link 12 Taniguchi K, Quacinella M, Barlow B. Squeaking Is Common and Increases Over Time Among Patients With Long-term Follow-up After Ceramic-on-ceramic THA. Clinical orthopaedics and related research 2021. link 13 Fan G, Xiang C, Li S, Gao Z, Liu X, He D et al.. Effect of placement of acetabular prosthesis on hip joint function after THA. Medicine 2019. link 14 Teufl W, Taetz B, Miezal M, Lorenz M, Pietschmann J, Jöllenbeck T et al.. Towards an Inertial Sensor-Based Wearable Feedback System for Patients after Total Hip Arthroplasty: Validity and Applicability for Gait Classification with Gait Kinematics-Based Features. Sensors (Basel, Switzerland) 2019. link 15 Boniello AJ, Lieber AM, Courtney PM. Are Patients Who Undergo THA for Infection at Higher Risk for 30-day Complications?. Clinical orthopaedics and related research 2019. link 16 Matharu GS, Berryman F, Dunlop DJ, Revell MP, Judge A, Murray DW et al.. No Threshold Exists for Recommending Revision Surgery in Metal-on-Metal Hip Arthroplasty Patients With Adverse Reactions to Metal Debris: A Retrospective Cohort Study of 346 Revisions. The Journal of arthroplasty 2019. link 17 Beckmann NA, Gotterbarm T, Innmann MM, Merle C, Bruckner T, Kretzer JP et al.. Long-term durability of alumina ceramic heads in THA. BMC musculoskeletal disorders 2015. link 18 Junnila M, Seppänen M, Mokka J, Virolainen P, Pölönen T, Vahlberg T et al.. Adverse reaction to metal debris after Birmingham hip resurfacing arthroplasty. Acta orthopaedica 2015. link 19 Frye BM, Berend KR, Lombardi AV, Morris MJ, Adams JB. Do sex and BMI predict or does stem design prevent muscle damage in anterior supine minimally invasive THA?. Clinical orthopaedics and related research 2015. link 20 Whitehouse MR, Masri BA, Duncan CP, Garbuz DS. Continued good results with modular trabecular metal augments for acetabular defects in hip arthroplasty at 7 to 11 years. Clinical orthopaedics and related research 2015. link 21 Whitehouse MR, Dacombe PJ, Webb JC, Blom AW. Impaction grafting of the acetabulum with ceramic bone graft substitute: high survivorship in 43 patients with a mean follow-up period of 4 years. Acta orthopaedica 2013. link 22 Uklejewski R, Rogala P, Winiecki M, Kędzia A, Ruszkowski P. Preliminary results of implantation in animal model and osteoblast culture evaluation of prototypes of biomimetic multispiked connecting scaffold for noncemented stemless resurfacing hip arthroplasty endoprostheses. BioMed research international 2013. link 23 Westacott DJ, McArthur J, King RJ, Foguet P. Assessment of cup orientation in hip resurfacing: a comparison of TraumaCad and computed tomography. Journal of orthopaedic surgery and research 2013. link 24 Savarino L, Cadossi M, Chiarello E, Baldini N, Giannini S. Do ion levels in metal-on-metal hip resurfacing differ from those in metal-on-metal THA at long-term followup?. Clinical orthopaedics and related research 2013. link 25 Huang DC, Tatman P, Mehle S, Gioe TJ. Cumulative revision rate is higher in metal-on-metal THA than metal-on-polyethylene THA: analysis of survival in a community registry. Clinical orthopaedics and related research 2013. link 26 García-Rey E, García-Cimbrelo E, Cruz-Pardos A. Cup press fit in uncemented THA depends on sex, acetabular shape, and surgical technique. Clinical orthopaedics and related research 2012. link 27 Howie DW, Costi K, McGee MA, Standen A, Solomon LB. Femoral bone is preserved using cemented polished stems in young patients. Clinical orthopaedics and related research 2012. link 28 Hart AJ, Skinner JA, Henckel J, Sampson B, Gordon F. Insufficient acetabular version increases blood metal ion levels after metal-on-metal hip resurfacing. Clinical orthopaedics and related research 2011. link 29 Girard J, Glorion C, Bonnomet F, Fron D, Migaud H. Risk factors for revision of hip arthroplasties in patients younger than 30 years. Clinical orthopaedics and related research 2011. link 30 Krych AJ, Pagnano MW, Coleman Wood K, Meneghini RM, Kaufman K. No strength or gait benefit of two-incision THA: a brief followup at 1 year. Clinical orthopaedics and related research 2011. link 31 Johansson HR, Johnson AJ, Zywiel MG, Naughton M, Mont MA, Bonutti PM. Does acetabular inclination angle affect survivorship of alumina-ceramic articulations?. Clinical orthopaedics and related research 2011. link 32 van den Akker-Scheek I, van Raay JJ, Reininga IH, Bulstra SK, Zijlstra W, Stevens M. Reliability and concurrent validity of the Dutch hip and knee replacement expectations surveys. BMC musculoskeletal disorders 2010. link 33 Della Valle CJ, Dittle E, Moric M, Sporer SM, Buvanendran A. A prospective randomized trial of mini-incision posterior and two-incision total hip arthroplasty. Clinical orthopaedics and related research 2010. link 34 Browne JA, Bechtold CD, Berry DJ, Hanssen AD, Lewallen DG. Failed metal-on-metal hip arthroplasties: a spectrum of clinical presentations and operative findings. Clinical orthopaedics and related research 2010. link 35 Lombardi AV, Berend KR, Seng BE, Clarke IC, Adams JB. Delta ceramic-on-alumina ceramic articulation in primary THA: prospective, randomized FDA-IDE study and retrieval analysis. Clinical orthopaedics and related research 2010. link 36 Mancuso CA, Graziano S, Briskie LM, Peterson MG, Pellicci PM, Salvati EA et al.. Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties. Clinical orthopaedics and related research 2008. link 37 Dixon T, Shaw M, Ebrahim S, Dieppe P. Trends in hip and knee joint replacement: socioeconomic inequalities and projections of need. Annals of the rheumatic diseases 2004. link 38 Prasad AK, Lim PL, Blackburn AZ, Cote MP, Ensor D, Succi MD et al.. Can Patients Differentiate Responses by Orthopaedic Surgeons and ChatGPT Regarding Total Hip Arthroplasty?. The Journal of the American Academy of Orthopaedic Surgeons 2026. link 39 Klimko A, Andronic O, Lu VYZ, Dimitriou D, Hoch A, Zingg PO. Survivorship and Patient-Reported Outcomes in Femoral Impaction Bone Grafting for Revision Hip Arthroplasty: A Systematic Review and Meta-Analysis of 4,102 Hips. The Journal of arthroplasty 2026. link 40 Crockatt WK, El-Othmani MM, Sarpong NO, Neuwirth AL, Cooper HJ, Herndon CL. Indications and Outcomes of Conversion Total Hip Arthroplasty via the Anterior and Posterior Approaches. The Journal of arthroplasty 2025. link 41 Sterneder CM, Springer B, Haralambiev L, Boettner F. Intraoperative measurement of cup inclination using fluoroscopy: do we need a different correction factor when using a different C-arm model. Archives of orthopaedic and trauma surgery 2025. link 42 Chavosh Nejad M, Vestergaard Matthiesen R, Dukovska-Popovska I, Jakobsen T, Johansen J. Machine learning for predicting duration of surgery and length of stay: A literature review on joint arthroplasty. International journal of medical informatics 2024. link 43 Muscatelli SR, Strait AV, Ho H, Dunn JR, Hopper RH, Fricka KB et al.. The CCJR® Charles A. Engh, Sr, MD. Excellence in Hip Research Award: The Evolution of Revision Hip Arthroplasty and Impact on the Trainee's Experience. The Journal of arthroplasty 2024. link 44 Wakeling CP, Wilson MJ, Whitehouse SL, Howell JR. Mixed manufacturer dual mobility bearing and the Exeter V40 Stem: is it safe? Short-term results in primary and revision hip replacement. Acta orthopaedica Belgica 2023. link 45 Harrington CJ, Lachance AD, Panarello NM, Slaven SE, Cody JP, Tracey RW. Running Following Hip Arthroplasty: A Systematic Review. Journal of surgical orthopaedic advances 2023. link 46 Duwelius PJ, Southgate RD, Crutcher JP, Rollier GM, Li HF, Sypher KS et al.. Registry Data Show Complication Rates and Cost in Revision Hip Arthroplasty. The Journal of arthroplasty 2023. link 47 Woelber E, Rana AJ, Springer BD, Kerr JM, Courtney PM, Krueger CA. Health Policy Views and Political Advocacy of Arthroplasty Surgeons: A Survey of the American Association of Hip and Knee Surgeons Members. The Journal of arthroplasty 2023. link 48 Reito A, Lainiala O, Berryman F, Dunlop DJ, Eskelinen A, Matharu GS. Long-term changes in blood metal ion levels in patients with hip resurfacing implants: implications for patient surveillance after 10 years follow-up. Hip international : the journal of clinical and experimental research on hip pathology and therapy 2023. link 49 Ninomiya K, Takahira N, Ikeda T, Suzuki K, Sato R, Kazuo H. Prevalence of frailty and associated factors among community-dwelling older adults after total hip arthroplasty. Hip international : the journal of clinical and experimental research on hip pathology and therapy 2023. link 50 Delanois RE, Sax OC, Wilkie WA, Douglas SJ, Mohamed NS, Mont MA. Social Determinants of Health in Total Hip Arthroplasty: Are They Associated With Costs, Lengths of Stay, and Patient Reported Outcomes?. The Journal of arthroplasty 2022. link 51 Jelsma J, Van Kuijk S, Buil I, Heyligers I, Grimm B, Schotanus M. Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA. Acta orthopaedica Belgica 2021. link 52 Ponzio DY, Rothermel SD, Chiu YF, Stavrakis AI, Lyman S, Windsor RE. Does Physical Activity Level Influence Total Hip Arthroplasty Expectations, Satisfaction, and Outcomes?. The Journal of arthroplasty 2021. link 53 Acuña AJ, Jella TK, Samuel LT, Schwarzkopf R, Fehring TK, Kamath AF. Inflation-Adjusted Medicare Reimbursement for Revision Hip Arthroplasty: Study Showing Significant Decrease from 2002 to 2019. The Journal of bone and joint surgery. American volume 2021. link 54 McClatchy SG, Rider CM, Mihalko WM, Pharr ZK, Toy PC. Defining Outpatient Hip and Knee Arthroplasties: A Systematic Review. The Journal of the American Academy of Orthopaedic Surgeons 2021. link 55 Salem HS, Harwin SF, Westrich GH, Delanois RE, Mont MA. Dual Mobility Acetabular Systems for Total Hip Arthroplasty: A Multicenter Study and Technique Report. Surgical technology international 2020. link 56 Castagnini F, Bordini B, Tassinari E, Stea S, Ancarani C, Traina F. Delta-on-Delta Ceramic Bearing Surfaces in Revision Hip Arthroplasty. The Journal of arthroplasty 2019. link 57 Erivan R, Matthieu PA, Boyer B, Reina N, Rhame M, Rouchy RC et al.. Use of morselized allografts for acetabular reconstruction during THA revision: French multicenter study of 508 cases with 8 years' average follow-up. Orthopaedics & traumatology, surgery & research : OTSR 2019. link 58 Fagotti L, Soares E, Bolia IK, Briggs KK, Philippon MJ. Early Outcomes After Arthroscopic Hip Capsular Reconstruction Using Iliotibial Band Allograft Versus Dermal Allograft. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2019. link 59 Benelli G, Maritato M, Cerulli Mariani P, Sasso F. Revision of ASR hip arthroplasty: analysis of two hundred and ninety six recalled patients at seven years. International orthopaedics 2019. link 60 Pattyn C, Willekens P, Audenaert E. Dual-mobility socket in challenging total hip arthroplasty: 2-6 years follow-up. Acta orthopaedica Belgica 2018. link 61 Etcheson JI, George NE, Gwam CU, Nace J, Caughran AT, Thomas M et al.. Trends in Total Hip Arthroplasty Under the Patient Protection and Affordable Care Act: A National Database Analysis Between 2008 and 2015. Orthopedics 2018. link 62 Ohmori T, Kabata T, Kajino Y, Taga T, Hasegawa K, Inoue D et al.. Differences in range of motion with the same combined anteversion after total hip arthroplasty. International orthopaedics 2018. link 63 Hoff T. The Battle Of The Bundle: Lessons From My Mother's Partial Hip Replacement. Health affairs (Project Hope) 2017. link 64 Copanitsanou P, Valkeapää K, Cabrera E, Katajisto J, Leino-Kilpi H, Sigurdardottir AK et al.. Total Joint Arthroplasty Patients' Education on Financial Issues and Its Connection to Reported Out-of-Pocket Costs-A European Study. Nursing forum 2017. link 65 Foucher KC. Preoperative gait mechanics predict clinical response to total hip arthroplasty. Journal of orthopaedic research : official publication of the Orthopaedic Research Society 2017. link 66 Shin JI, Keswani A, Lovy AJ, Moucha CS. Simplified Frailty Index as a Predictor of Adverse Outcomes in Total Hip and Knee Arthroplasty. The Journal of arthroplasty 2016. link 67 Jakobs O, Schmidl S, Schoof B, Beckmann J, Gehrke T, Gebauer M. Increased risk for extended acetabular reconstruction in failed hip resurfacing as compared to failed total hip arthroplasty. 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The Journal of arthroplasty 1997. link90000-0)

Original source

[1]
Comparison of Uncemented and Hybrid Hip Arthroplasty: Protocol for a Brazilian Randomized Controlled Trial. — Souza BGSE, Lacerda ID, Vasconcelos MM, Furtado NL, Vieira JM, Souza ISF et al. JMIR research protocols (2026)
[2]
Pulsed electromagnetic field therapy versus sham therapy as an adjunct to conventional physiotherapy on pain, functional disability, and quality of life in patients undergoing total hip arthroplasty: a randomized placebo controlled trial protocol. — Gharjare A, Deshmukh M Trials (2026)
[3]
Acceptability of a Digital Care App in Patients Undergoing Hip and Knee Arthroplasty: Prospective Cohort Study. — Louni Y, Laroche M, Alnasser A, Abuhaneya M, Belzile E, Baskaran S et al. JMIR human factors (2026)
[4]
Preoperative Sarcopenia Severity and Clinical Outcomes after Total Hip Arthroplasty. — Tanaka S, Kayamoto A, Terai C, Nojiri S, Fugane Y, Mori T et al. Nutrients (2024)
[5]
Simultaneous bilateral total hip arthroplasty-a survey of Irish orthopaedic surgeons' practice. — Doyle TR, Davey MS, Toale JP, O'Driscoll C, Murphy CG Irish journal of medical science (2024)
[6]
Total Hip Arthroplasty in Teenagers: A Systematic Literature Review. — Te Velde JP, Buijs GS, Schafroth MU, Saouti R, Kerkhoffs GMMJ, Kievit AJ Journal of pediatric orthopedics (2024)
[7]
How is hip anatomy reconstruction and inlay wear associated up to 10 years after primary THA using ceramic on highly crosslinked polyethylene bearings? — Weishorn J, Heid S, Bruckner T, Merle C, Renkawitz T, Innmann MM BMC musculoskeletal disorders (2023)
[8]
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Femoral Vessel Blood Flow Is Preserved Throughout Direct Anterior Total Hip Arthroplasty. — Stryker LS, Gilliland JM, Odum SM, Mason JB The Journal of arthroplasty (2015)
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