[Total joint arthroplasty and bone quality--atrophic OA [osteoarthrosis] and stovepipe canal--]

Durability of total hip arthroplasty (THA) has been improved after serial innovations in prosthetic design and material and in surgical technology. Consequently, bone quality of the hip joint has emerged as an important risk factor limiting durability of a contemporary THA. Subchondral bone or eburnated bone in the acetabular roof should be preserved for the long-term durability of the socket. In atrophic osteoarthrosis (OA), i.e., OA with little osteophyte formation, prevalence of socket loosening was higher than in OA with osteophyte formation. Femoral components fixed in the proximal femur with a stovepipe canal (a wide and cylindrical canal) were more likely to develop loosening than the others. These bone-quality problems should be solved to further improve durability of THA.