Does Hip Resurfacing Require Larger Acetabular Cups Than Conventional THA?

Abstract

Hip resurfacing is femoral bone preserving, but there is controversy regarding the amount of bone removed at the acetabular side. We therefore compared the implanted acetabular cup sizes in primary THAs between two resurfacing devices and a conventional press-fit cup using a series of 2134 THAs (Allofit 1 cup 1643 hips, Durom 1 Hip Resurfacing 249 hips, and Birmingham Hip

Hip resurfacing arthroplasty: current status and future perspectives

“…This is the reason why some surgeons try to downsize the femoral component as much as possible thereby increasing the risk of notching with disrupting the blood supply and neck/ socket impingement. However, other studies have shown that the acetabular component size in HRA is comparable to cementless THA (Venditolli et al, 2006;Moonot et al, 2007;Brennan et al, 2009;Naal et al, 2009). There are no data available whether the pelvic bone stock would be compromised for revision surgery of HRA.…”

“…Others found a high level of sports activities after HRA surgery, with older patients being more active than younger patients (Naal et al, 2007). More patients participated more frequently in sports activities with a longer duration of activities following HRA (Narvani et al, 2006;Banerjee et al, 2010). However, there was a decrease in high-impact activities with an increase in low-impact activities found in another survey of 138 patients at a mean of 2 years post-operatively (Banerjee et al, 2010).…”

“…Refractive groin pain (6%) was another presumptive aseptic indication for HRA revision in Australia . HRA appears to be associated with a higher prevalence of groin pain than conventional THA (18% versus 0.4-7%, respectively) (Ala Eddine et al, 2001;O'Sullivan et al, 2007;Bartelt et al, 2010;Nasser et al, 2010). Potential factors leading to groin pain include a proud anterior socket rim, neck-socket or iliopsoas impingement, hypersensitivity to metal ions, higher activity level and possibly higher expectations for patients receiving MoM bearing surfaces that might make those patients more likely to report postoperative pain (Taher and Power, 2003;Willert et al, 2005;Korovessis et al, 2006;O'Sullivan et al, 2007;Khanduja and Villar, 2008).…”

“…In addition, smaller components may be more vulnerable to less optimal component positioning in the sagittal plane, as minor degrees of malalignment may lead to an increased risk of impingement because of the relative decrease in the head-neck ratio (Kluess et al, 2008). Neck-socket impingement may lead to microseparation, rim damage and groin pain, eventually leading to revision surgery (Lavigne et al, 2008b;Nikolaou et al, 2009). Smaller diameter components might predispose to periprosthetic fractures because the femoral stem is often not proportionally sized, with the result that it is relatively thicker versus the femoral neck.…”

“…Functional outcomes and quality of life following HRA Patients treated with HRA have been noted to have high postoperative activity levels and quality of life scores (Narvani et al, 2006;Naal et al, 2007), which are higher than those of their THA counterparts (Pollard et al, 2006;Vail et al, 2006;Lavigne et al, 2008a;Mont et al, 2009) -even after adjustments for pre-operative activity levels (Zywiel et al, 2009). One study reported that more HRA patients returned to work (96%) and heavy to moderate activities (72%) 1 year postoperatively than THA patients (66% and 39%, resp.).…”