Removal of acetabular bone in resurfacing arthroplasty of the hip

Abstract

The Journal of Bone and Joint Surgery. British volumeVol. 88-B, No. 6 CorrespondenceFree AccessRemoval of acetabular bone in resurfacing arthroplasty of the hipR. F. SPENCERR. F. SPENCERSearch for more papers by this authorPublished Online:1 Jun 2006https://doi.org/10.1302/0301-620X.88B6.18084AboutSectionsPDF/EPUB ToolsDownload CitationsTrack CitationsPermissionsAdd to Favourites ShareShare onFacebookTwitterLinked InRedditEmail Sir,I read this article with interest. It confirms the widely-held impression that resurfacing hip arthroplasty may not be conservative in relation to acetabular bone when compared with hybrid hip replacement. The results coincide with similar evidence published elsewhere.1Loughead et al2 recommend using the smallest femoral component compatible with the avoidance of femoral notching to minimise the extent of acetabular bone resection. Such narrow margins, if widely applied, may result in a certain number of cases of notching, with possible damage to the blood supply to the femoral head.3 Moreover, it has been suggested by Amstutz et al4 that small components in male patients may predispose to early revision.Too much emphasis may have been given to the issue of bone conservation on the acetabular side in hip resurfacing, and recent designs incorporating thinner (more conservative) acetabular shells have resulted in an increased number of early revisions.5 Accurate templating and selection of implants may be the most appropriate course to take. It should be remembered that revision of hip resurfacing more commonly involves the femoral side only and patterns of osteolysis and further bone destruction are not comparable with those seen following the use of cementless acetabular components with polyethylene liners in hybrid hip arthroplasty. References 1 Crawford JR, Palmer SJ, Wimhurst JA, Villar RN. Bone loss at hip resurfacing: A comparison with total hip arthroplasty. Hip International 2005;15:195–8. Crossref, Medline, ISI, Google Scholar2 Loughead JM, Starks I, Chesney D, et al. Removal of acetabular bone in resurfacing arthroplasty of the hip: a comparison with hybrid total hip arthroplasty. J Bone Joint Surg [Br] 2006;88-B:31–4. Link, Google Scholar3 Beaule PE, Campbell PA, Hoke R, Dorey F. Notching of the femoral neck during resurfacing arthroplasty of the hip. J Bone Joint Surg [Br] 2006;88-B:35–9. Link, Google Scholar4 Amstutz HC, Beaule PE, Dorey FJ, et al. Metal-on-metal hybrid surface arthroplasty: Two to six-year follow-up study. J Bone Joint Surg [Am] 2004; 86-A:28–39. Google Scholar5 Australian Orthopaedic Association National Joint Registry 2005. Google ScholarFiguresReferencesRelatedDetailsCited byComparison of patient-reported outcomes between hip resurfacing and total hip replacementE. A. Lingard, K. Muthumayandi, J. P. Holland1 December 2009 | The Journal of Bone and Joint Surgery. British volume, Vol. 91-B, No. 12Birmingham hip resurfacing IS ACETABULAR BONE CONSERVED?P. Moonot, P. J. Singh, M. D. Cronin, Y. E. Kalairajah, T. G. Kavanagh, R. E. Field1 March 2008 | The Journal of Bone and Joint Surgery. British volume, Vol. 90-B, No. 3A randomised study comparing resection of acetabular bone at resurfacing and total hip replacementP.-A. Vendittoli, M. Lavigne, J. Girard, A. G. Roy1 August 2006 | The Journal of Bone and Joint Surgery. British volume, Vol. 88-B, No. 8 Vol. 88-B, No. 6 Metrics History Published online 1 June 2006 Published in print 1 June 2006 InformationCopyright © 2006, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download