[Total hip replacement: current concepts and basic issues]

Since the pioneering period of the early 1960s, total hip replacement has gained in safety, effectiveness and quality, through advances in anesthesia, pain control and less-invasive surgery. New materials have been developed jointly with engineers. Thirty years ago we started to develop a special friction system with alumina on an alumina couple, which avoids osteolysis due to plastic debris. It has also become possible to implant hip prostheses in young people, permitting normal activity and with the hope of keeping the same prosthesis for many years. The authors also review data on foreign body reactions, biomechanics, and bone remodeling.