Advancements in total hip arthroplasty over time

Osteoarthritis of the hip is defined as the degeneration of the cartilage of the femoral head and the acetabulum. It is considered the most common chronic joint disease, with a major impact on functional disability and immobility in the elderly population. According to epidemiological studies, the prevalence of radiographic osteoarthritis of the hip is estimated at 8%, with estimations for symptomatic osteoarthritis of up to 3.9% and 5.1% in the male and female population, respectively. Due to continuous ageing of the population, along with an increasing prevalence of obesity and other risk factors, an increasing socioeconomic burden for the healthcare system is likely. The invention and continuous improvement of total hip arthroplasty can be considered one of the most important milestones in orthopaedic surgery during the last century. While prostheses have standardly been implanted via the transgluteal approach, novel minimally invasive techniques without detachment of musculature or dissection of nerve structures have been developed. This technique, namely implantation of the implant via the anterior approach, have been postulated to be associated with a lower level of postoperative pain, a shorter rehabilitation period, a shorter length of stay, a shorter operative scar, a decreased amount of blood loss and a faster return to daily activities. Furthermore, rapid recovery programs have been developed with the aim to reduce the length of hospital stay in order to enable the patient with a rapid return to daily life.