[Replacement of a failed total hip prosthesis].

At the present time, apart from infectious complication, failed total hip prosthesis essentially consist of detached prosthesis. On the basis of their experience of eight thousand arthroplasties, including more than 6,000 Charnley prosthesis, performed over a period of 18 years, the authors propose three basic principles designed to ensure a long term satisfactory result: steel on polyethylene prosthesis, diameter 22 and fixation with acrylic cement. They consider that this approach can offer a second chance to patients with a detached prosthesis, especially when the technique of the first arthroplasty was faulty or if a poor quality prosthesis was used. The authors' experience has confirmed that the second operation should aim to restore an arthroplasty as close as possible to normal anatomy. The authors have satisfactorily achieved this aim by the wide use of homografts.