Restrictive, slow progressive and long course disease

Hip osteoarthritis is a common form of osteoarthritis and a major cause of restricted locomotor activity and functional disability that may progress to the point where joint replacement is unavoidable.
Total hip replacement achieves excellent technical outcomes with 10-year survival exceeding 95%, 25-year implant survival greater than 80%, and significant benefits for pain, mobility, and physical function.

Critical actions

  • Anamnesis and physical exam performance
  • Request exams that lead to a decision about appropriateness of surgical treatment


  • 1st Medical consultation
  • Follow-up consultation
  • Treatment
  • Follow-up
  • Referral
  • Patient education
  • Emergency
  • Inpatient


  • Shan L, Shan B, Graham D, Saxena A. Total hip replacement: a systematic review and meta-analysis on mid-term quality of life. Osteoarthritis Cartilage. 2014;22(3):389-406. doi:10.1016/j.joca.2013.12.006
  • Maslowski E, Sullivan W, Forster Harwood J, Gonzalez P, Kaufman M, Vidal A, et al. The diagnostic validity of hip provocation maneuvers to detect intra-articular hip pathology. PM R. 2010;2(3):174–81.
  • Huang BK, Tan W, Scherer KF, Rennie W, Chung CB, Bancroft LW. Standard and advanced imaging of hip osteoarthritis. What the radiologist should know. Semin Musculoskelet Radiol. 2019;23(3):289–303.
  • Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–89.
  • Cheng TE, Wallis JA, Taylor NF, Holden CT, Marks P, Smith CL, et al. A prospective randomized clinical trial in total hip arthroplasty-comparing early results between the direct anterior approach and the posterior approach. J Arthroplasty. 2017;32(3):883–90.
  • Miller LE, Gondusky JS, Bhattacharyya S, Kamath AF, Boettner F, Wright J. Does surgical approach affect outcomes in total hip arthroplasty through 90 days of follow-up? A systematic review with meta-analysis. J Arthroplasty. 2018;33(4):1296–302.
  • Peters RM, van Beers LWAH, van Steenbergen LN, Wolkenfelt J, Ettema HB, Ten Have BLEF, et al. Similar superior patient-reported outcome measures for anterior and posterolateral approaches after total hip arthroplasty: Postoperative patient-reported outcome measure improvement after 3 months in 12,774 primary total hip arthroplasties using the anterior, anterolateral, straight lateral, or posterolateral approach. J Arthroplasty. 2018;33(6):1786–93.
  • De Anta-Díaz B, Serralta-Gomis J, Lizaur-Utrilla A, Benavidez E, López-Prats FA. No differences between direct anterior and lateral approach for primary total hip arthroplasty related to muscle damage or functional outcome. Int Orthop. 2016;40(10):2025–30.
  • Aggarwal VK, Weintraub S, Klock J, Stachel A, Phillips M, Schwarzkopf R, et al. 2019 Frank Stinchfield Award: A comparison of prosthetic joint infection rates between direct anterior and non-anterior approach total hip arthroplasty: A single institution experience. Bone Joint J. 2019;101-B(6_Supple_B):2–8.
  • Lovelock TM, Broughton NS. Follow-up after arthroplasty of the hip and knee: Are we over-servicing or under-caring? Bone Joint J. 2018;100-B(1):6–10.
  • Evans JT, Evans JP, Walker RW, Blom AW, Whitehouse MR, Sayers A. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647–54.
  • Karachalios T, Komnos G, Koutalos A. Total hip arthroplasty: Survival and modes of failure. EFORT Open Rev. 2018;3(5):232–9.
  • Tan TL, Le Duff MJ, Ebramzadeh E, Bhaurla SK, Amstutz HC. Long-term outcomes of liner cementation into a stable retained shell: A concise follow-up of a previous report: A concise follow-up of a previous report. J Bone Joint Surg Am. 2015;97(11):920–4.
  • Scanelli JA, Reiser GR, Sloboda JF, Moskal JT. Cemented femoral component use in hip arthroplasty. J Am Acad Orthop Surg. 2019;27(4):119–27.
  • Karachalios TS, Koutalos AA, Komnos GA. Total hip arthroplasty in patients with osteoporosis. Hip Int. 2020;30(4):370–9.
  • López-López JA, Humphriss RL, Beswick AD, Thom HHZ, Hunt LP, Burston A, et al. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis. BMJ. 2017;359:j4651.

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