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Semin Musculoskelet Radiol 2015; 19(01): 003-011
DOI: 10.1055/s-0034-1396762
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Principles of Design and Fixation

Alberto Carli
1   Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, New York
,
Seth Jerabek
1   Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, New York
› Author Affiliations
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Publication History

Publication Date:
29 January 2015 (online)

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Abstract

Total joint arthroplasty refers to the restoration of joint function and stability through bony and ligamentous reconstruction. It is considered among the most reliable and reproducible surgical procedures in modern medicine and expected to increase drastically in demand over the next 20 years. This article provides an overview of the rationale behind implant design and how fixation in arthroplasty, specifically total hip arthroplasty, is achieved. The biomechanics of the hip joint and its associated radiologic landmarks are reviewed. This is then followed by a description of the design features of acetabular and femoral components, with concise explanations of why cemented and cementless implants exist, how different implant geometries and porous coatings address specific clinical needs, and how we hope the current innovations in cementless fixation will improve outcomes in revision surgery.

Keywords

total hip arthroplasty - hip biomechanics - cemented femoral component design - osseointegration - cementless femoral component design
 

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