The young osteoarthritic hip

Total hip arthroplasty (THA) has proven to be a highly successful procedure in terms of improving quality of life and cost-effectiveness in older patients (Ethgen et al. 2004, Räsänen et al. 2007). With this success, an extension of indications for total hip arthroplasty was noted and the number of primary hip arthroplasties in Europe has risen to more than 600,000 annually (Labek et al. 2009). Many different types of hip prostheses are currently available. Historically, hip prostheses are categorised according to their method of fixation: with or without bone cement.

The development of the modern cemented hip prosthesis (Figure 1) started in the 1960s with the low friction arthroplasty designed by Sir John Charnley (Charnley 1961). The design was eventually based on the use of a metal stem with a fixed 22 mm head, which articulates with a polyethylene cup.