The 4 R’s of Modern Adult Hip Surgery: From Regeneration and Reconstruction to Replacement and Revision

Dear Colleagues,

The past decades have witnessed tremendous efforts to increase the quality of care of patients suffering from congenital or acquired hip disorders. The modern concept of femoro-acetabular impingement and our steadily growing understanding of the mechanisms that lead to instability of the hip joint have created new therapeutic pathways, the real potential of which we are just beginning to recognize. Hip arthroscopy and joint preservation techniques such as the Bernese periacetabular osteotomy have become the standard of care for patients with prearthritic deformities and nowadays some of these reconstructive techniques can even be performed via minimally-invasive approaches. Recent advances in Tissue Engineering & Regenerative Medicine (TE&RM) have triggered a paradigm shift in therapeutic decision making away from methods to replace damaged articular and periarticular structures with inert implants to more biological solutions that focus on regeneration of tissue defects with smart biomaterials or cell-based platforms. Nevertheless, hip replacement still remains the mainstay of therapy for advanced osteoarthritis. Although total hip arthroplasty is referred to as one of the most successful and effective surgical procedures of our times, it still offers room for improvements. Implantation techniques, “enhanced recovery after surgery” (ERAS) - protocols and implant materials are constantly being developed further, and nowadays, the use soft tissue sparing approaches such as the direct anterior approach is steadily increasing for both primary and revision hip replacement.  

The present Special Issue aims to present an overview about cutting-edge developments in adult hip surgery: From Regeneration and Reconstruction to Replacement and Revision.

Prof. Dr. Boris Michael Holzapfel
Guest Editor

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