Dramatic advances have occurred recently in three areas of orthopedic surgery: total joint arthroplasty, spine surgery, and arthroscopy.
The first results of modern total hip arthroplasty (THA) were reported by Charnley1 in 1961. The American experience began in 1968. Although THA performed in the 1970s produced a revision rate of approximately 10% at 10 years,2,3 radiological review of these patients suggested a higher rate of impending failure with time. It was generally assumed that the weak link in THA was fixation by bone cement. These observations gave impetus to the development of cementless arthroplasty as an alternative, particularly for younger, active patients. Concomitantly, improved prosthetic designs and cementing techniques have improved the results of cemented THA.
Femoral component loosening in the first 5 to 10 years after surgery is now far less likely when using modern cementing techniques4-6 and is seemingly well controlled in the initial experience