Factors associated with implant survival following total hip replacement surgery: A registry study of data from the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man.

Background: Nearly 100,000 people underwent total hip replacement (THR) in the United Kingdom in 2018, and most can expect it to last at least 25 years. However, some THRs fail and require revision surgery, which results in worse outcomes for the patient and is costly to the health service. Variation in the survival of THR implants has been observed between units and reducing this unwarranted variation is one focus of the "Getting it Right First Time" (GIRFT) program in the UK.

The SPAIRE technique allows sparing of the piriformis and obturator internus in a modified posterior approach to the hip.

Introduction: The Sparing Piriformis and Internus, Repair Externus (SPAIRE) technique allows a muscle sparing mini-posterior approach to the hip.

Method: We present in this article a description of an adaptation of the familiar posterior approach (PA) in which the only tendon released is obturator externus. Termed SPAIRE, this muscle sparing technique enables preservation of the piriformis tendon and conjoint insertion of obturator internus and the gemelli.

Dislocation after total hip replacement - there is no such thing as a safe zone for socket placement with the posterior approach.

Introduction: Malorientation of the socket contributes to instability after hip arthroplasty but the optimal orientation of the cup in relation to the pelvis has not been unequivocally described. Large radiological studies are few and problems occur with film standardisation, measurement methodology used and alternative definitions of describing acetabular orientation.

Methods: A cohort of 1,578 patients from a single institution is studied where all patient data was collected prospectively.