Introduction

I choose hip implants which, wherever possible, have a proven track record in published, peer reviewed medical journals, and presentations at international meetings. I also try to use prostheses which allow me use as wide a variety of bearings (gliding surfaces) as possible so that I can tailor a hip to each individual.

For young active patients I use the uncemented Corail, which in the huge Scandinavian Joint Registries, gives by far the best performance of any cementless stem.

Studies show over 95% of hips still functioning well at twenty years, once again amongst the best in the world. It also allows use of larger heads to optimize function, with ceramic or metal technology.

The cemented stem of choice is the C-stem, developed in the same unit as Charnley’s original work. It uses the polished tapered design originally introduced by the Exeter system, but takes it further by loading the very top of the femur to improve bone strength even further. In fact, in at least one fifth of patients, the bone actually gets stronger after the implantation of this hip.

For the cup, the Pinnacle allows modern large bearings, and has a 5A rating from the national ODEP committee, as good a rating as possible given its age. It is a direct development of the Duraloc, which with a rating of 10A was the most reliable component of its time.

When looking at hip resurfacing, the Birmingham device has been around for longer, and is better followed up than any comparable component. This gives a real feeling of reassurance for a predominantly young patient group who need to rely on the replacement for so many years.

Studies show 95% implant survival at 8 years, including all the early failures affecting any resurfacing device (2-4% in the first 6-12 months).