The content for this Annual Hip Society Proceedings Symposium is based on the Fall 2008 Closed Meeting in Chicago and the Open Scientific Meeting of the Hip Society that occurred in conjunction with the 2009 Annual Meeting of AAOS. The organization and content of these programs were superbly managed by Drs. Wayne Paprosky and Daniel Berry.
As one would expect, a large portion of the content for these meetings was related to the continued followup and investigation of complications related to alternative bearing surfaces in hip arthroplasty. Followup has now matured to mid- and long-term followup with ceramic surfaces and it has become clear that the durability of this surface appears favorable. The unforeseen complication of squeaking has diminished the enthusiasm associated with this technology and current investigations are focused on the etiology and potential elimination of this sometimes disconcerting acoustical phenomenon.
Early to midterm followup of metal-on-metal articulating surfaces has started to emerge with a clearer picture of the potential advantages and disadvantages of this bearing surface. Reports of local soft tissue reactions related to metal ion hypersensitivity with metal-on-metal articulations (which up to this point have only been anecdotal), are now emerging and appear to be quite concerning. The full ramifications of this adverse reaction to metal-on-metal bearing surfaces are yet unknown but are uncomfortably similar to the reports of complications associated with metal-on-metal bearings in the 1970s.
It is quite clear from the content of this symposium that the next several years will provide more clarity with regard to the complications related to the hard-on-hard alternative bearing surfaces. The combination of metal-on-ceramic as a bearing surface is intriguing, particularly when juxtaposed with information becoming available with the currently offered hard-on-hard bearing surfaces.
Other topics include long-term evaluation of uncemented primary femoral fixation which has been almost universally successful with all second generation implants and modern designs at long-term followup. Additional symposium topics include the success of porous metals when used in acetabular revision, the evaluation of periacetabular osteolysis, and a variety of femoral revision topics. The remainder of the symposium includes miscellaneous areas related to both primary and revision hip arthroplasty and ongoing interest related to femoral acetabular impingement.
The overall content of this symposium is contemporary and should prove to be very interesting and informative for individuals involved with hip surgery. As is true with all issues that are evaluated scientifically, many of these reports raise additional questions and issues that require ongoing investigation and study. On behalf of the Hip Society, we hope you enjoy and that your patients benefit from the information provided by this symposium.