THE RATIONALE FOR TOTAL HIP-REPLACEMENT IN OVER 60-YEAR-OLD PATIENTS

The total hip replacement (THR) survival potential is linked to the ma terial, to surgical technique and to patient's characteristics. Cement ed and cementless systems exist in a wide variety of shapes, sizes, co nfigurations, materials and surface treatments. Aseptic loosening rema in the principal mechanism of prosthetic failure and the choice of rig ht matching for each prosthesis-patient is the main issue to obtain a very good long-term implant fixation. Cement fixation is always solidl y achieved but it can break down under mechanical and biological press ure. Stability with cementless fixation must be created by the initial bone response to the implant. Clinical studies and long-term results with THR showed that in patients with age between 60 and 70 years, it is important to analyze several parameters (bone quality and morpholog y, life-limiting diseases and levels of activity) to make the appropri ate selection of components and type of fixation.