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Published online by Cambridge University Press: 01 August 2008
Primary total hip replacement (THR) is one of the most common and cost-effective major operations performed in the developed world: annually approximately 50,000 are undertaken in England and Wales and over half a million are performed worldwide. The majority of these operations are performed for primary or secondary osteoarthritis (over 75% from Swedish data), traumatic fracture (11.3%) or rheumatoid arthritis (6%), but indications are varied and include avascular necrosis, congenital dislocation, Paget's disease, and ankylosing spondylitis. The primary goal of the procedure is the relief of pain that can no longer be controlled by analgesia or non-operative procedures, but severely impaired mobility affecting independence is a secondary indication.