Primary Hip Replacement

Hip replacement involves the use of a socket and a ball for the femoral head. These components could be fixed to the bone either with the help of bone cement (cemented THR) or as a press fit (uncemented THR). Both these techniques have shown good results over 15-20 years follow-up.

Various factors decide the choice between cemented or uncemented technique, namely, the age, the bone quality, cost issues and to some extent also the surgeon’s preference. However, the experience over the last 40 years worldwide seems to show that the press fit (uncemented) technique has given the best results for the cup fixation. So far as the stem is concerned both the techniques have shown good results.
The reasons for failure of this surgery is mainly due to the wear of the polyethylene cup. Hence, in the last 10-15 years there has been a renewed interest in the use of other materials which are wear resistant current computer aided manufacturing technique enable highly polished surfaces that are ideal for this surgery, like Metal-on-Metal and Ceramic-on-Ceramic. These have shown very low wear rates.

Cemented
A 69 year old gentleman presented with secondary arthrosis of the left hip joint. Treated with the hybrid total hip replacement (cemented femur with uncemented socket)

 Before Surgery After Surgery
 Before Surgery  Post Surgery

Hybrid
A 72 year old gentle man with primary arthrosis of the right hip joint. Treated with the cemented total hip replacement.

 Before Surgery After Surgery
 Hybrid  Hybrid

New design
75 year old gentleman from Oman presented with severe deformity of the hip with painful arthritis. Treated with uncemented total hip replacement with the modern large head metal-on-metal prosthesis. This system allows much more movements in the hip.

 Before Surgery After Surgery
 Hybrid  Hybrid

Uncemented
Idiopathic avascular necrosis in a 30 year old gentle man treated with the conventional non cemented total hip replacement.

 Before Surgery After Surgery
 Hybrid  Hybrid

An example of ceramic-on-ceramic total hip replacement.

 Before Surgery After Surgery
 Hybrid  Hybrid

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