Soft-tissue balancing of the hip: the role of femoral offset restoration.

Inadequate soft-tissue balancing is a major yet often underemphasized cause of failure for primary and revision total hip arthroplasty. Accordingly, contemporary cemented and cementless hip prostheses have been designed with consideration of this issue, and this has substantially increased the long-term survival of total hip replacements. Therefore, it is important for orthopaedic surgeons to be familiar with the rationale, biomechanical principles, and clinical implications associated with soft-tissue balancing of the hip as well as strategies to avoid inadequate soft-tissue balancing and systematic techniques to restore adequate soft-tissue tensioning during total hip arthroplasty.