1. What ar ethe Current Indications for Total Hip Replacement (THR)?

suitable for nearly anyone with cronic untreatable pain and evidence of joint damage

patient’s goals and expectations should be discussed beforehand

not enough data on specific indicators or contraindicators

2. What ar the Design and Surgical Considerations Relating to a Replacement Prosthesis?

long-term fixation

particulate material

less favorable results of revision surgery

3. What are the Responses of the Biological Environment?

osteolysis due to particulate matter or the cement (deterioration of the bone)

4. What are the Expected Outcomes?

over 90% of joints are never revised

need preadmission education and to find out what sort of rehabilitation is appropriate

need to define (technically) what failure is

highest rates of THR in men 65-74 years old and women 75-84 years old

much higher rates in whites than blacks and wealthy

5. What are the Accepted Approaches and Outcomes for Revision of THR?

significant bone loss, fracture, dislocation, malposition, and infection--consider Revision

infections are devestating but are well controlled

6. What are the most Productive Directions for Future Research?

standard assesment criteria

issues of age, sex, weight, and activity level

race

materials

national registry to look at items recovered from cadavers

Conclusions

option for nearly all cronic pain and significant functional imparement patients

long term faliure generally a result of particulate matter and subsequent inflamation

continued follow up needed (revision is not as good)

better methods for evaluation