Total hip arthroplasty across the lifespan: A systematic review of biomechanical changes, functional outcomes, and surgical access

Abstract

Total hip arthroplasty (THA) is a prevalent surgical intervention designed to restore mobility and diminish pain in individuals grappling with end-stage hip disorders. This systematic review offers a detailed evaluation of the impact of aging, biomechanical alterations, functional responses, and surgical approaches on THA outcomes. Aging influences recovery through physiological and cognitive declines, underscoring the need for customized perioperative care. Biomechanical considerations, such as implant positioning, fixation, and material choice, are crucial for ensuring long-term implant stability and optimal joint function. Functional recovery hinges on the restoration of muscle strength and the implementation of effective gait retraining programs, with rehabilitation serving as a cornerstone. Different surgical approaches present distinct risks and benefits related to soft tissue preservation and complication profiles. Emerging technologies, including robotic-assisted surgery and enhanced recovery protocols, advance precision and rehabilitation efficiency. Despite these improvements, challenges persist in optimizing THA for the elderly and addressing complex clinical cases. Future directions involve personalized implants, AI-guided planning, and mobile rehabilitation to enhance patient outcomes.