Abstract
Background A further two changes to the technique of primary Total Hip Arthroplasty (THA) have recently been advocated, computer assisted surgery and access by mini incision(s). These add to the potential different ways the surgeon can perform THA and are still in an early evolutionary stage. However, they add further fuel to the question, what is the best technique for THA ?
Method We considered the procedure of THA and broke it down into the main component stages. We then assessed the various possible different options for each different stage from the literature and a survey of 14 Orthopaedic Surgeons (6 consultants, 2 associate specialists and 6 trainees).
Results We calculate that THA can be performed by at least 1.08 x 1011 different unique techniques. We were unable to find any consensus on the best technique for THA.
Conclusions This massive diversity causes problems with informed consent, research and training. NICE and NJR have issues regarding choice of implant but we believe the choice of surgical technique for THA can play an even more important role in outcome.
Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.