Current status of total joint arthroplasty: observations and projections

The 10-20 year results and complications of the first generation of total hip arthroplasties suggest that early problems such as infection, component breakage, and early loosening have been controlled, but that late aseptic loosening is now the major problem. Newer approaches will bring with them a new set of complications which must be carefully monitored. A standardized rating scheme and computerized information bank will allow more rapid analysis of trends and problems. A number of joint preserving alternatives to total replacement are available but intervention must be early, before a salvage situation exists.