Total hip arthroplasty: survival and modes of failure

Total hip arthroplasty (THA) is a very satisfactory surgical procedure for end-stage hip disorders. Implant modifications, such as large femoral heads to improve stability, porous metals to enhance fixation and alternative bearings to improve wear, have been introduced over the last decade in order to decrease the rate of early and late failures. There is a changing pattern of THA failure modes. The relationship between failure modes and patient-related factors, and the time and type of revision are important for understanding and preventing short and late failure of implants. The early adoption of innovations in either technique or implant design may lead to an increased risk of early failure.