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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1,
31-34.
doi: 10.1302/0301-620X.88B1.16764 Copyright © 2006 by British Editorial Society of Bone and Joint Surgery Removal of acetabular bone in resurfacing arthroplasty of the hipA COMPARISON WITH HYBRID TOTAL HIP ARTHROPLASTYJ. M. Loughead, MRCS, Specialist Registrar in Orthopaedics1; I. Starks, MRCS, Clinical Fellow in Orthopaedics1; D. Chesney, FRCS, Specialist Registrar in Orthopaedics1; J. N. S. Matthews, PhD, CStat, Professor of Medical Statistics2; A. W. McCaskie, MD, FRCS(Orth), Professor of Orthopaedics1; and J. P. Holland, FRCS(Orth), Consultant in Trauma and Orthopaedics1
1 Department of Trauma and Orthopaedic Surgery Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK. Correspondence should be sent to Mr J. M. Loughead at Department of Orthopaedics Level 2 Secretaries, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK; e-mail: Jonathan{at}Loughead.fsworld.co.uk
Resurfacing arthroplasty of the hip is being performed more frequently in the United Kingdom. The majority of these patients are younger than 55 years of age, and in this group the key benefits include conservation of femoral bone stock and the potential reduction in the rate of dislocation afforded by the larger resurfacing head. Early aseptic loosening is well recognised in patients younger than 55 years of age, and proponents of resurfacing believe that the improved wear characteristics of the metal-on-metal bearing may improve the long-term survival of this implant. There has been some concern, however, that resurfacing may not be conservative of acetabular bone. We compared a series of 33 consecutive patients who had a hybrid total hip arthroplasty with an uncemented acetabular component and a cemented femoral implant, with 35 patients undergoing a Birmingham hip resurfacing arthroplasty. We compared the diameter of the implanted acetabulum in both groups and, because they were not directly comparable, we corrected for patient size by measuring the diameter of the contralateral femoral head. The data were analysed using unpaired t-tests and analysis of covariance. There was a significantly larger acetabulum in the Birmingham arthroplasty group (mean diameter 56.6 mm vs 52.0 mm; p < 0.001). However, this group had a significantly larger femoral head diameter on the contralateral side (p = 0.03). Analysis of covariance revealed a significant difference between the mean size of the acetabular component implanted in the two operations. The greatest difference in the size of acetabulum was in those patients with a larger diameter of the femoral head. This study shows that more bone is removed from the acetabulum in hip resurfacing than during hybrid total hip arthroplasty, a difference which is most marked in larger patients. This article has been cited by other articles:
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