title: Total hip arthroplasty at the rothman institute.
abstract: BACKGROUND
  Total hip arthroplasty (THA) is one of the most successful surgical interventions devised in modern times. Attempts to change the current THA procedure with unproven innovations bring the risk of increased failure rates while trying to improve the benefit of the surgery.
  
  
  OBJECTIVE
  This manuscript examines the evolution of THA at the Rothman Institute illustrating the key elements that lead the success of this procedure at this institution. These key elements include femoral stem design, use of highly crossed-linked polyethylene and use of pain and rehabilitation protocols. We attempted to describe the long-term results regarding safety, effectiveness, and durability of specific THA implant designs used at this institution drawing on reported evidence in the literature.
  
  
  METHODS
  The authors performed a review of peer-reviewed articles related to the Rothman Institute's experience with THA.
  
  
  RESULTS
  Total hip arthroplasty is an efficient, safe, and durable procedure. It is a highly successful operation to restore function and improve pain. The survivorship of THA procedures at the Rothman Institute is higher than 99% at 10 years based on mechanical failure. The use of collarless, tapered wedge femoral stem, highly crossed-linked polyethylene, and improved pain rehabilitation protocols have contributed to this success.
  
  
  CONCLUSIONS
  There is a well-documented long-term survivorship after THA. Future innovation in THA should address new challenges with younger and more demanding patients, rather than change current methods that have a proven good survivorship. This innovation depends mainly upon improvements in the bearing surfaces and advances in pain control and rehabilitation.
authors.affiliation: Rotham Institute, Thomas Jefferson University, 925 Chestnut St., 5th Floor, Philadelphia, PA 19107 USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Austin
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Higuera
authors.forename: Richard H
authors.initials: RH
authors.lastname: Rothman
keywords: Arthroplasty; Hip; Total