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Purpose of review: The review is intended to describe the most recent evidence surrounding the use of hydroxyapatite-coated uncemented femoral stems. Recent findings: Until recently, the research on hydroxyapatite-coated femoral stems has been limited to retrospective and prospective studies with short-term follow-up. Recently, several authors have published 10–15-year follow-up data that are very promising. Hydroxyapatite is a good adjunct for fostering bony ingrowth and ongrowth of femoral components. This in turn results in less pain, faster onset of implant stability, and a lower incidence of aseptic loosening. Summary: A proximally coated press-fit femoral component augmented with a hydroxyapatite coating provides predictable outcome and may be favored as a state of the art or gold standard for primary hip arthroplasty.

Purpose of review Total hip replacement is one of the safest and most clinically efficacious operations in orthopedic surgery. It has been extended to more and more patient populations over the past four decades. The purpose of this review is to present the contemporary data of total hip replacement in two unique patient populations: obese patients and geriatric patients older than 75 years of age. Recent findings There are unique clinical challenges in these patients. In addition, the clinical outcome and complications are different from more routine total hip replacement populations. Summary The recent research has shown that total hip replacement in the obese and elderly populations can be successful, and should not be denied solely based on these two criteria. There is a need for more research to investigate postoperative instability in the obese patient population, and perioperative mental confusion and cognitive function deterioration in the elderly patient population.

Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA Correspondence to Michael H. Huo, MD, Department of Orthopedic Surgery, UT Southwestern Medical Center, 1801 Inwood Road, Dallas, TX 75390-8883, USA Tel: +1 214 645 3368; fax: +1 214 645 3340; e-mail: [email protected]

Purpose of review: The purpose of this review is to analyze the outcomes of the posterior stabilized total knee arthroplasty and review the most recent literature relevant to this topic. Recent findings: Despite the dissimilarities between cruciate retaining and posterior stabilized total knee arthroplasty designs, most studies have found no significant differences in function, patient satisfaction, or survivorship of the two designs in unselected patient cohorts. Posterior stabilized total knee arthroplasty outcomes, however, are better in a particular subgroup of patients including patients with patellectomy, large varus or varus-flexion deformity and rheumatoid arthritis. Summary: Posterior stabilized implants in total knee arthroplasty have design features that limit excessive tibial translation, after resection of the posterior cruciate ligament. Intraoperative and postoperative benefits of a posterior stabilized total knee arthroplasty over a cruciate retaining total knee arthroplasty include easier ligament balancing, easier correction of severe deformity by eliminating a tight posterior cruciate ligament, increased predictability in restoration of knee kinematics, improved range of motion, and potentially minimized polyethylene wear because of the option to use more congruent articular surfaces. Potential disadvantages with posterior stabilized total knee arthroplasty include tibial post polyethylene wear, soft-tissue impingement, and the risk of dislocation or instability in flexion.