Hip Reconstruction

otal hip arthroplasty (THA) remains one of the most T successful and financially efficacious reconstructive operations in orthopedic surgery. Many innovative surgical techniques and implant designs have been introduced into clinical application over the past decade. The principal focus of this particular symposium is to present the most contemporary clinical data on several such new innovations in THA. The invited authors are all themselves experts in the specific topics selected by the Section Editor. Increasing data have become available to document the clinical efficacy of cementless fixation in THA. There is near consensus agreement on the clinical efficacy and fixation durability of hemispherical or elliptical acetabular cups, with or without adjunct screws or spikes, using cementless fixation. Some controversies remain with regard to the optimal biomaterial, implant geometry, surface texture, and extent of porous-coating in cementless stems. Keggi, Kennon, and Keggi have contributed information on the use of modular femoral stems. Modularity has the advantage of fulfilling individual patient’s anatomical and reconstructive prerequisites during surgery. It also offers easier preparation and insertion through limited-incision surgical approaches. It has the potential problems of fretting, corrosion and other mechanical failures at the modular junctions, however. These surgeons have collectively performed over 900 THAs using five different contemporary modular stems. These were all inserted using a modified anterior minimalinvasive (MIS) surgical approach. There was no increased rate of dislocation, calcar fractures, or infection when compared to the surgeons’ previous experience with nonmodular designs. There were four mechanical fractures at the neck–stem taper junction in one particular design [total series of 163 stems (2.5%)]. No further breakage occurred since modifications were made in the design. There were three loose stems in the entire series (0.3%) in short-term follow-up. Markel and Gheraibeh presented an excellent review of evidence-based data on femoral stems coated with hydroxyapatite (HA). They specifically separated the reported results in the literature into short-, mid-, and long-term clinical follow-up. Matched-comparative studies of HA-coated and non-HA-coated stems of identical biomaterial, surface texture, and geometry have all demonstrated no significant