(iv) Managing interface problems in revision total hip arthroplasty

Total hip arthroplasty remains one of the highly successful surgical intervention and consistently produces predictable outcomes in the majority of patients. The failure rate increases as more physically active and younger patients undergo the procedure. As life expectancy of the general population increases, so too will the requirement for revision THA. The THAs performed in the 1970s had loosening rates of 30–40% by 10 yrs. Improvements in surgical techniques, prosthetic designs and biomaterials have improved the longevity of the prostheses, with now only 3% of the femoral components and 10% of the acetabular components requiring revision surgery at 10–15 years. The mode of failure can be multifactorial. The type of revision operation depends on the failures at the various interfaces and a good outcome can be produced consistently if the interface problems are managed appropriately.