North Hampshire Hospital
The Hampshire Clinic
Basingstoke, Hampshire, UK

Mr John Britton FRCS
Consultant Orthopaedic Surgeon

Information for patients undergoing orthopaedic treatment



Advances in hip replacement

Although the 'standard' hip replacement comprising a cemented stem, a metal ball and a plastic cup has stood the test of time well there remain some unresolved problems:

  • Wear of the plastic cup becomes a significant problem after about 10 years

  • Revision of a cemented stem remains a major surgical challenge

For these reasons current research is aimed at improving the bearing surfaces so that they do not wear and to finding a better means of fixing the replacement to bone.

Bearing surfaces
A number of different bearing surfaces are currently being investigated. Heads are now made out of either cobalt chrome or ceramic, whilst modified high density polyethylene, ceramic and cobalt chrome cups are being used

Ceramic on ceramic bearing Metal on metal bearing

Device fixation
Many prosthesis now have a porous coating that is covered in a substances known as hydroxyapatite. This encourages bone to 'grow' into the replacement giving excellent fixation. The results of this type of prosthesis are very encouraging.
An alternative approach is to simply put a cap over the ball of the hip; this is known as the Birmingham Resurfacing hip.

Minimally invasive surgery
Recently there has been considerable interest in performing hip replacement through very small incisions, which may speed recovery. Basingstoke is one of the major centres in the UK which has been leading this research.

Which is best?
With so many different replacements available it is difficult to choose a single best option. Indeed there is no such thing, since the prosthesis has to be matched to the individual patient. You will have a chance to discuss this fully before your surgery.

J M Britton 2007

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