Surgical management of joint problems has progressed drama­ tically in the past few years. Clearer understanding of the patho­ genesis of joint disorders and recent additions to our knowledge of joint mechanics have mage formerly unimagined procedures possible. Moreover, tremendous advancement in implant tech­ nology offers us a wider variety of surgical procedures and a better chance of obtaining satisfactory results. At the same time, alternative bone-preserving procedures, such as osteotomy, in the weight-bearing joints are still of great significance in selected cases. In this context, it is clear that international collaboration and coordination of scientific endeavours is crucial. Over the last decade, thanks to the great assistance given by contributors to this book, we have tried to coordinate our endeavors on the interna­ tional level without being restricted to our own societies. There­ fore, it was fitting that the symposium was held in an effort to bring together experts in the field of joint surgery to share their specialized knowledge. We hoped that the free interchange of ideas would bring about an updated understanding and provide knowledge essential to the treatment of joint disease. KAzuSHI HIROHATA Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Part 1. Recent Advances and Problems in Total Joint Replacement Biomechanics of Endoprostheses of the Hip and Adaptive Reactions of the Bone B. KUMMER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Management of Femoral Bone Stock Deficiency in Total Hip Replacement H. P. CHANDLER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . . . . . . . . Bone Grafting ofAcetabular Deficiencies in Total Hip Replacement A. H. WILDE, B. N. STULBERG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Surgical management of joint problems has progressed drama­ tically in the past few years. Clearer understanding of the patho­ genesis of joint disorders and recent additions to our knowledge of joint mechanics have mage formerly unimagined procedures possible. Moreover, tremendous advancement in implant tech­ nology offers us a wider variety of surgical procedures and a better chance of obtaining satisfactory results. At the same time, alternative bone-preserving procedures, such as osteotomy, in the weight-bearing joints are still of great significance in selected cases. In this context, it is clear that international collaboration and coordination of scientific endeavours is crucial. Over the last decade, thanks to the great assistance given by contributors to this book, we have tried to coordinate our endeavors on the interna­ tional level without being restricted to our own societies. There­ fore, it was fitting that the symposium was held in an effort to bring together experts in the field of joint surgery to share their specialized knowledge. We hoped that the free interchange of ideas would bring about an updated understanding and provide knowledge essential to the treatment of joint disease. KAzuSHI HIROHATA Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Part 1. Recent Advances and Problems in Total Joint Replacement Biomechanics of Endoprostheses of the Hip and Adaptive Reactions of the Bone B. KUMMER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Management of Femoral Bone Stock Deficiency in Total Hip Replacement H. P. CHANDLER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . . . . . . . . Bone Grafting ofAcetabular Deficiencies in Total Hip Replacement A. H. WILDE, B. N. STULBERG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A half century ago, orthopedic surgeons needed to specialize in only the pathophysiology and treatment of the neuromuscular and skeletal systems in order to treat patients. However, since then, surprising progress has been made in medicine, and through the limitless avenues for research orthopedics is now divided into many subspecialities, with terms such as orthopedic pathology, orthopedic oncology, orthopedic rheumatology, and orthopedic traumatology becoming commonplace. Interdisciplinary studies in this and other related fields are now indispensible. As a result, the half-life of the information accumulating yearly has been estimated at five years. In times such as these, if one stubbornly adheres to treatment alone, progress comparable to that in other fields will not be made. If one opens an orthopedic textbook, it is easy to see that there are still many diseases of undetermined etiology; in the last quarter of a century, there has been no evidence of even one of these diseases'' etiology having been resolved internationally. This is a direct result of the ineptitude of basic orthopedic research. Therefore, recently in the United States, Japan and Canada, orthopedic research institutes and associations have been established, and SIROT has been organized internationally. This book contains the manuscripts presented by international and Japanese speakers at the 5th Annual Meeting of the Orthopedic Research Society of the Japanese Orthopedic Association, and the Second Inter­ national Cherry Blossom Conference of Rheumatology.

Surgical management of joint problems has progressed drama­ tically in the past few years. Clearer understanding of the patho­ genesis of joint disorders and recent additions to our knowledge of joint mechanics have mage formerly unimagined procedures possible. Moreover, tremendous advancement in implant tech­ nology offers us a wider variety of surgical procedures and a better chance of obtaining satisfactory results. At the same time, alternative bone-preserving procedures, such as osteotomy, in the weight-bearing joints are still of great significance in selected cases. In this context, it is clear that international collaboration and coordination of scientific endeavours is crucial. Over the last decade, thanks to the great assistance given by contributors to this book, we have tried to coordinate our endeavors on the interna­ tional level without being restricted to our own societies. There­ fore, it was fitting that the symposium was held in an effort to bring together experts in the field of joint surgery to share their specialized knowledge. We hoped that the free interchange of ideas would bring about an updated understanding and provide knowledge essential to the treatment of joint disease. KAzuSHI HIROHATA Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Part 1. Recent Advances and Problems in Total Joint Replacement Biomechanics of Endoprostheses of the Hip and Adaptive Reactions of the Bone B. KUMMER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Management of Femoral Bone Stock Deficiency in Total Hip Replacement H. P. CHANDLER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . . . . . . . . Bone Grafting ofAcetabular Deficiencies in Total Hip Replacement A. H. WILDE, B. N. STULBERG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Surgical management of joint problems has progressed drama­ tically in the past few years. Clearer understanding of the patho­ genesis of joint disorders and recent additions to our knowledge of joint mechanics have mage formerly unimagined procedures possible. Moreover, tremendous advancement in implant tech­ nology offers us a wider variety of surgical procedures and a better chance of obtaining satisfactory results. At the same time, alternative bone-preserving procedures, such as osteotomy, in the weight-bearing joints are still of great significance in selected cases. In this context, it is clear that international collaboration and coordination of scientific endeavours is crucial. Over the last decade, thanks to the great assistance given by contributors to this book, we have tried to coordinate our endeavors on the interna­ tional level without being restricted to our own societies. There­ fore, it was fitting that the symposium was held in an effort to bring together experts in the field of joint surgery to share their specialized knowledge. We hoped that the free interchange of ideas would bring about an updated understanding and provide knowledge essential to the treatment of joint disease. KAzuSHI HIROHATA Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Part 1. Recent Advances and Problems in Total Joint Replacement Biomechanics of Endoprostheses of the Hip and Adaptive Reactions of the Bone B. KUMMER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Management of Femoral Bone Stock Deficiency in Total Hip Replacement H. P. CHANDLER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . . . . . . . . Bone Grafting ofAcetabular Deficiencies in Total Hip Replacement A. H. WILDE, B. N. STULBERG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A half century ago, orthopedic surgeons needed to specialize in only the pathophysiology and treatment of the neuromuscular and skeletal systems in order to treat patients. However, since then, surprising progress has been made in medicine, and through the limitless avenues for research orthopedics is now divided into many subspecialities, with terms such as orthopedic pathology, orthopedic oncology, orthopedic rheumatology, and orthopedic traumatology becoming commonplace. Interdisciplinary studies in this and other related fields are now indispensible. As a result, the half-life of the information accumulating yearly has been estimated at five years. In times such as these, if one stubbornly adheres to treatment alone, progress comparable to that in other fields will not be made. If one opens an orthopedic textbook, it is easy to see that there are still many diseases of undetermined etiology; in the last quarter of a century, there has been no evidence of even one of these diseases'' etiology having been resolved internationally. This is a direct result of the ineptitude of basic orthopedic research. Therefore, recently in the United States, Japan and Canada, orthopedic research institutes and associations have been established, and SIROT has been organized internationally. This book contains the manuscripts presented by international and Japanese speakers at the 5th Annual Meeting of the Orthopedic Research Society of the Japanese Orthopedic Association, and the Second Inter­ national Cherry Blossom Conference of Rheumatology.