title: Disease and specific considerations in total hip replacements.
abstract: Total hip replacement arthroplasty has evolved where multiple options may be provided to the patient depending on disease, age, activity level, bone quality, and bone geometry. For elderly patients, the hybrid hip (uncemented acetabular and cemented femoral components) is widely used. In the young active population, uncemented porous bone ingrowth designs predominate. Special considerations involving the total hip patient include management of blood loss anemia, prevention of infection, and prevention of heterotopic ossification. Autologous blood donation as well as collection and infusion of shed blood in the postoperative patient greatly minimize the need for homologous transfusions. Optimizing the surgical environment, meticulous and efficient surgical technique, and antibiotic prophylaxis continue to be the cornerstones of infection prevention. Nonsteroidal anti-inflammatory medication and radiation are effective means of preventing heterotopic ossification.
authors.affiliation: Reconstructive Orthopaedic Surgeons, P.A., Dallas, Texas.
authors.forename: W C
authors.initials: WC
authors.lastname: Head
authors.forename: A D
authors.initials: AD
authors.lastname: Cuellar
authors.forename: R H
authors.initials: RH
authors.lastname: Emerson
authors.forename: P C
authors.initials: PC
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001168:Arthritis / Q000601:surgery; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006622:Hip Prosthesis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control