Recent advances in adult hip joint surgery.

This article is a summary of the information published in the field of hip surgery in adults over the past year. It reviews the epidemiology and economic aspects of total hip replacement, which dominates adult hip surgery, and examines the long-term results and complications that occur with both cemented and uncemented arthroplasty of the hip. Aseptic loosening is a major problem in the long-term outcome of total hip replacement. Wear of the bearings with production of particulate debris induces a local inflammatory response, activating the bone resorbing cells. Accordingly, revision surgery has become a frequent procedure that raises difficult problems. Strategy, methods, implant design, grafting, and indication for cemented or noncemented total hip replacements are discussed.