The Future of High Performance Total Hip Arthroplasty

Balancing longevity with high performance depends on numerous intraoperative and postoperative factors. Intraoperatively, longevity can be affected by surgical approach, pain management, and instrumentation. Utilizing anesthetic pain management with muscle-sparing surgical approaches and computer-assisted instrumentation can provide improved results. Postoperatively, longevity is dependant on rehabilitation, implant design, and activity level. Individualized and comprehensive rehabilitation protocols are the critical foundation of longevity. Cementless technology and improvements in bearing surfaces (new polyethelenes, ceramic-on-ceramic interfaces) may help to improve alignment and fixation. Implant performance can be improved through advanced instrumentation, disease specific designs, and the use of navigation.