Total hip replacement: the current perspective after 37 years

The first hip replacements of the modern era were performed by Sir John Charnley in 1959,using poly- tetrafluoroethylene for the acetabulum and polymethylmethacrylate cement to secure the stainless steel femoral component. These initial operations were not a success due to excessive wear of the PTFE bearing surface. The operation was not acknowledged to be the success it is today until 1962when Charnley switched to using high-density polyethylene for the acetabular component and the "low-friction arthroplasty" was introduced.' This prosthesis has remained the "gold standard" until the present day with relatively few changes to the original concept, and with considerable success with published results in excess of 20 years.'