International Programs

Background. Hip replacements are considered routine operations which improve the quality of life in patients by reducing pain and restoring function. There are many variations in prostheses with varying benefits and disadvantages.
Methods. Literature from the United States and Europe was collected on total hip replacements between 2001 and the present and analyzed based on outcome measures and survivorship.
Results. Studies generally use revision as end point with few studies measuring patient satisfaction. The Charnley style metal-on-polyethylene implants still show the most consistent results long term. Metal on metal and ceramic on ceramic show reduced wear and osteolysis, the main indication for revision, so may prove better when more long term studies become available.
There are so many implants that long term studies are not actually feasible due to options entering and leaving the market on a rapid basis.
Conclusions. Large-scale, long term, independent studies are needed to compare available choices. Immediate feedback is also necessary to keep up with new products.
The creation of a national registry in the US and standardized outcome measurements would allow large scale conclusions to be made on the benefits and risks of each implant design and approach, giving doctors, engineers, and patients an invaluable source of information for use in decision making.