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Surgical Approaches to OA Therapy: Osteotomy and Arthroplasty


Total hip and knee replacement are among the most successful surgical procedures in medicine. The long-term survival of total hip replacements for which both the femoral and acetabular components were fixed to the surrounding bones with cement demonstrates durable results, even in young patients. For example, 35-year follow-up of cemented total hip replacements revealed a survival rate of 78% with the need for revision surgery for any reason as the end point . In younger patients, the 25-year survival is 93% for the femoral component, though only 77% for the cemented acetabular component.

The introduction of newer designs that relies on biologic fixation through bone ingrowth into porous coatings on the metallic components has also proven durable. Twenty-year survival of porous-coated acetabular components has been reported at 86% with revision for any reason associated with the acetabular component as the end point. In a direct comparison of cemented and cementless acetabular components performed by the same surgeon, survival at 18 years improved from 81% to 94%. Long-term results for porous-coated femoral components are just as impressive.

Joint replacement patients enjoy function which is comparable to their peers without osteoarthritis. Patient-reported outcomes such as the short-form health outcomes survey (the SF-36), together with objective functional measures, such as the 6-min walk, show no meaningful differences between total hip patients and normative values.

This article appears in HSS Journal: Volume 8, Number 1.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


John J. Callaghan, MD
Department of Orthopaedics, University of Iowa, VA Medical Center
Iowa City, Iowa


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