Instructional Course Lecture   |    
Bearing Surface Options for Total Hip Replacement in Young Patients
Christian Heisel, MD; Mauricio Silva, MD; Thomas P. Schmalzried, MD
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An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

Christian Heisel, MD
Mauricio Silva, MD
Thomas P. Schmalzried, MD
Joint Replacement Institute at Orthopaedic Hospital, 2400 South Flower Street, Los Angeles, CA 90007

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Deutsche Forschungsgemeinshaft and Los Angeles Orthopaedic Hospital Foundation. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (DePuy, a Johnson and Johnson Company). Also, a commercial entity (DePuy, a Johnson and Johnson Company) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2004 in Instructional Course Lectures, Volume 53. The complete volume can be ordered online at www. aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Look for these related articles in Instructional Course Lectures, Volume 53, which will be published by the American Academy of Orthopaedic Surgeons in March 2004:
• "The Diagnosis and Treatment of Nontraumatic Osteonecrosis of the Femoral Head," by Gracia Etienne, MD, PhD, Michael A. Mont, MD, and Phillip S. Ragland, MD
• "The Diagnosis and Treatment of Labral and Chondral Injuries," by Joseph C. McCarthy, MD

J Bone Joint Surg Am, 2003 Jul 01;85(7):1366-1379
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Total hip arthroplasty is one of the most successful and cost-effective surgical interventions in medicine1 and is the most effective treatment for osteoarthritis of the hip joint. Long-term studies of selected patient cohorts2-4 and the Scandinavian hip registries5,6 have demonstrated high survivorship rates after more than twenty years. On the basis of this success, total hip replacement is being performed on increasingly younger and more active patients. However, there are at least two problems that a young or active patient faces with regard to the prosthetic joint. First, the use of the implant is more intense in proportion to their physical activities7. Second, the patient's life expectancy is longer and the potential total number of loading cycles is increased proportionally.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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