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Source: [PDF]  Blue Book HIPBritish Orthopaedic Association

Total hip replacement has been one of the most spectacularly successful innovations in modern medicine and in the United Kingdom over 50,000 such operations were carried out in 2003 and the number continues to rise1,2,3.
This is the revised version of the original document produced under the leadership of Hugh Phillips in October 1999, 4. He was President of both the British Orthopaedic Association, the British Hip Society and The Royal College of Surgeons of England.

I was given the task of coordinating the revision process. At the outset acknowledgement must be given to the late Hugh Phillips for producing what was a
ground-breaking document. Helped by his Steering Group and other contributors, a
consensus statement was produced that was acceptable to the membership of both the British Orthopaedic Association and the British Hip Society. We know that the first edition of this document has been of help to Clinicians in setting standards of patient care 5 and, as the first such document, it led the way in development of other good practice guidelines in orthopaedics.

The first version acknowledged that it was an interim statement, and five years later we are addressing the changes in practice and environment that have occurred. The object of this guide is to ensure the best possible care for patients undergoing primary total hip replacement in the United Kingdom.

As with the first edition it is hoped that this guide will inform surgeons, primary and
secondary healthcare providers and commissioners. It is not designed to inform
patients but it may form the basis for patient-focussed information. This edition of
the guide will also require revision in time.

Primary total hip replacement as described in this document includes any procedure on the hip joint that entails the insertion of artificial bearing surfaces. No previous
major operations have been performed on that joint.

The first document dealt solely with ‘classical’ total hip replacement and excluded
hip resurfacing. The latter procedure has become widely used in the United
Kingdom and is included in the scope of this document.

The standards laid down in this document apply to the practice of primary hip
replacement in any setting, be it National Health Service (NHS), Private Practice or

The creation of such a consensus document involves help from many experts. I
acknowledge and thank those who have made this task possible. Their names are
recorded in the appendices.

James Nixon

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