Chronology of Total Hip Joint Replacement and Materials Development

The development of hip joint materials is one of the most challenging problems to prostheses technology in this millennium. Several types of materials have been developed for this purpose. The materials like glass, polymer (poly-tetra-fluoro-ethylene / PTFE or Teflon and ultra-high-molecular-weight-polyethylene or UHMWPE), metal (stainless steel, CoCr alloy, and CoCrMo alloy), ceramics (alumina, zirconia, Ti-coated ceramic alloys, and high isostatic pressed alumina or HIPed Al2O3), composite, and apatite materials have been tried with partial success. Currently, Hydroxyapatite (HA) is being used quite frequently all over the world. Hip joint replacement techniques have been discussed under four different classifications i.e. hip arthroplasty, femoral stem, acetabular cup, and finally, total hip arthroplasty (THA). Chronology of technical improvement over first generation alternative joint bearing technologies before 1950s, have been presented by Charnley and other scientists. Before 1960s, there was hardly any technique with predictable results. The modern Charnley’s low-friction UHMWPEon-metal technique was the actual invention of the total hip replacement (THR) technique. The main objective of this paper is to list all the efforts in the direction of total hip replacement technique and material development chronologically. All historical and recent efforts for developing suitable materials and various designs have been covered in detail. Towards the end of the paper, the current trends and direction in material development techniques and the areas of research have also been emphasized.