Hip Arthroplasty implant selection is an art. Considerable time and thought is devoted to each patient during this selection process, as femoral geometry, size, and bone quality are radiographically assessed and matched to the ideal implant. As such, a variety of stem options are employed in my practice. These stem options include stems manufactured by Smith and Nephew (Anthology, Polar, Redapt, Spectron), Zimmer/Biomet (MLT, Echo Microplasty, Versys Heritage), and DePuy (S-ROM).
The acetabular component (socket implant) has less variation and is typically selected based on bone quality, the need to manage any acetabular defects, and the presence of dysplasia. Almost uniformly, the acetabular components I use are composed of porous titanium alloy to enhance bony ingrowth and achieve long lasting fixation. The bearing couple I employ is dependent on the stability of the joint. Typically standard bearing couples are utilized, composed of Oxinium or Biolox Delta ceramic femoral head components and highly cross-linked polyethylene acetabular liners. Some patients may require increased stability or have a higher demand on range of motion following their hip replacement. In these instances a dual mobility bearing is typically utilized to allow for a larger femoral head size.
In the revision hip replacements, bone loss is frequently encountered and is usually managed with longer stemmed femoral components. Revision hip arthroplasty may also require socket augmentation with either porous metal augments or cadaveric bone grafting.