Total hip replacement is one of the most common orthopaedic reconstructive procedures performed today, with more than 40 000 replacements completed annually in Canada. New surgical techniques and materials have led to procedures that produce profound changes in the lives of patients and allow them to resume virtually all of their previous activities. Sir John Charnley developed low-friction art...

In the past 20th century, during the sixties, a successful replacement of a pathologic hip joint was finally achieved. It was the first arthroplasty of the hip providing a good functional outcome. This new technique was described by Charnley in 1961 (Charnley, 1961). Two materials were then introduced in the orthopedic surgery, the polyethylene and the polymethyl methacrylate. This later is kno...

Arthrodesis of the hip has been employed since the late 19th century. Late complications can arise decades after fusion in patients who were previously asymptomatic. We describe two patients who developed pain in the hip many years after a successful fusion. There was no infection or loosening of the implants. After careful investigation, including oblique radiographs and diagnostic injections ...

The revision of well fixed total hip arthroplasty components can be a challenging surgical procedure, especially if the femoral component is stable and well integrated into the medullary cavity. It can be necessary to create a cortical bone window in the diaphysis to effectively remove all the remaining fragments of polymethylmethacrylate. This was just one of the problems associated with cemen...

Osteonecrosis of the hip accounts for about 10% of all total hip arthroplasty cases and presents a significant challenge for those patients with and without femoral head collapse. Subtrochanteric femur fractures have been reported with numerous types of proximal femoral implants. Care must be taken to avoid penetrating the lateral cortex of the proximal femur inferior to the distal border of th...

Aside from the decision-making in how to fix an extracapsular hip fracture, surgeons must be conversant with systems, implants and how to maximize their potential in the shortest operative time. We present a series of steps used in our unit when performing both DHS and intramedullary nail surgery to avoid the commonest problems and maximize our patients' recovery potential.

The historical success of orthopedic implants has been recently tempered by unexpected pathologies and early failures of some types of Cobalt-Chromium-Molybdenum alloy containing artificial hip implants. Hypoxia-associated responses to Cobalt-alloy metal debris were suspected as mediating this untoward reactivity at least in part. Hypoxia Inducible Factor-1α is a major transcription factor invo...

AIM To evaluate the clinical and X-ray results of acetabular components and tantalum augments in prosthetic hip revisions. METHODS Fifty-eight hip prostheses with primary failure of the acetabular component were reviewed with tantalum implants. The clinical records and X-rays of these cases were retrospectively reviewed. Bone defect evaluations were based on preoperative CT scans and classifi...

Hip simulators have been used for ten years to determine the tribological performance of large-head metal-on-metal devices using traditional test conditions. However, the hip simulator protocols were originally developed to test metal-on-polyethylene devices. We have used patient activity data to develop a more physiologically relevant test protocol for metal-on-metal devices. This includes sto...

Osteogenesis imperfecta is a rare inherited disorder of connective tissue which may present with recurrent fractures which are prone to nonunion and malunion resulting in deformity. Some patients develop osteoarthritis of the hip. Formation of hyperplastic callus after recurrent fractures may deform the shape of the femur and preclude the use of standard implants at joint replacement. Replaceme...