Total hip arthroplasty : State of the art, prospects and challenges

Abstract

Recently increasing revision rates of certain types of metal-on-metal (MoM) hip prostheses [1], introduced on the medical device market during the last decade, have created uncertainty concerning the safety and effectiveness of artificial hip joints [2]. Eventhough medical progress is generally expected to be a continuous process leading to improved medical treatment, problems occured with some hip-resurfacing systems that failed to deliver the expected improvement. Moreover, this created severe health problems for many patients worldwide [2]. This report reviews the historical development and the state-of-the-art of total hip arthroplasty from a biomedical engineering point of view and illustrates the motivation for the efforts to improve the quality of hip prostheses. The report also aims at explaining the peculiar problems related to evaluating the safety and effectiveness of hip prostheses, which are supposed to last for at least 20 to 25 years. Furthermore, it addresses some medical and biological aspects of total hip arthroplasty (THA).JRC.I-Institute for Health and Consumer Protection (Ispra