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4. BONE PRESERVATION
Equal socket bone is removed but less femoral bone is removed with HRA.
Most important for the younger patient who is more likely to require revision surgery in their lifetime.
If the hip arthroplasty (THR or HRA) has failed, one or both implants have to be removed and replaced by new ones (revision). There is always bone loss associated with implant failure and/or removal. On the socket side, this is the same for both HRA and THR. On the femoral side, there is a distinct advantage for HRA. HRA femoral failures require revision to a stemmed THR, but the standard femoral neck cut that is done for primary THR is all that is required. An HRA femoral revision is no different than a primary (1st time) femoral stem for a THR. A revision of the femoral side of a THR usually involves much more surgical time, blood loss, and bone damage. A longer stem is then used to reconstruct.
If all else is equal, it is always better to preserve your bone for the future.