the acetabular inclination and the acetabular anteversion are measurements of cup angulation in the coronal plane and the sagittal plane, respectively. Alternatives and variations Conservative management The first line approach as an alternative to hip replacement is conservative management which involves a multimodal approach of oral medication, injections, activity modification and physical therapy. Conservative management can prevent or delay the need for hip replacement. Preoperative care Preoperative education is an important part of patient care. Some evidence indicates that it may slightly reduce anxiety before hip or knee replacement, with low risk of negative effects. Hemiarthroplasty Hemiarthroplasty is a surgical procedure that replaces one half of the joint with an artificial surface and leaves the other part unchanged. This class of procedure is most commonly performed on the hip after an intracapsular fracture of the femur neck (hip fracture). The procedure is performed by removing the head of the femur and replacing it with a metal or composite prosthesis. The most commonly used prosthesis designs are the Austin Moore and Thompson prostheses. A composite of metal and HDPE that forms two interphases (bipolar prosthesis) can be used. The monopolar prosthesis has not been shown to offer any advantage over bipolar designs. The procedure is recommended only for elderly/frail patients, due to their lower life expectancy and activity level. This is because over time the prosthesis tends to loosen or to erode the acetabulum. Independently mobile older adults with hip fractures may benefit from a total hip replacement instead of hemiarthroplasty. Hip resurfacing Hip resurfacing is an alternative to hip replacement surgery. It has been used in Europe since 1998 and became a common procedure. Health-related quality of life measures are markedly improved and patient satisfaction is favorable after hip resurfacing arthroplasty. The minimally invasive hip resurfacing procedure is a further refinement to hip resurfacing. Viscosupplementation Viscosupplementation is the injection of artificial lubricants into the joint. Use of these medications in the hip is off label. The cost of treatment is typically not covered by health insurance. Some authorities claim that the future of osteoarthritis treatment is bioengineering, targeting the growth and/or repair of the damaged, arthritic joint. Centeno et al. reported on the partial regeneration of an arthritic human hip joint using mesenchymal stem cells. It is yet to be shown that this result will apply to a large group of patients and result in significant benefits. The FDA stated