The use of primary total hip arthroplasty in university hospitals of the European Union.

Current practice in primary total hip replacement was investigated by postal survey in 125 university hospitals of the European Union (EU). Most hospitals (78.4%) use a hip register and implant cemented as well as uncemented stems (72.0%) and cups (68.8%). In Scandinavian & Anglo-Saxon countries, 42.9% of the departments implant cemented stems in all their patients, and 16.7% implant cemented cups in all their patients. In these countries, modern cementing techniques are commonly used and therapeutic choices are strongly influenced by hip registers. In Southern Europe, cemented cups have been abandoned in 31.1% and modern cementing techniques are less common. Benelux & Germanic countries have a practice in between. Three cemented (Exeter, Charnley, Lubinus) and three uncemented stems (Zweymüller, ABG, Bi-contact) represent 41.9% and 25.3% of stem types in use. Most departments (70.4%) have adopted alternative bearings. Ceramic-ceramic and metal-metal are both used in almost half of the hospitals. Metal-polyethylene has been abandoned in 15.2%. These trends are taught to new generations of surgeons in the EU and could become common practice in a near future.