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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 1, 9-15.
doi: 10.1302/0301-620X.89B1.18011  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The femoral head/neck offset and hip resurfacing

P. E. Beaulé, MD, FRCSC, Associate Professor1; N. Harvey, MD, Orthopedic Resident2; E. Zaragoza, MD, Associate Clinical Professor3; M. J. Le Duff, MA, Clinical Research Co-ordinator2; and F. J. Dorey, PhD, Professor and Statistitician4

1 Department of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital, 501 Smyth Road, Suite 5004, Ottawa K1H 8L6, Ontario, Canada.
2 Joint Replacement Institute, University of Southern California, 2400 South Flower Street, Los Angeles, California 90007, USA.
3 Department of Radiology, Santa-Monica UCLA Medical Center, 1245 16th Street, Santa Monica, California 90404, USA.
4 Department of Pediatrics, Norris University of Southern California Cancer Center, 657-OPT Children’s Hospital, 4650 Sunset Boulevard, Los Angeles, California 90027, USA.

Correspondence should be sent to Dr P. E. Beaulé; e-mail: pbeaule{at}Ottawahospital.on.ca

Because the femoral head/neck junction is preserved in hip resurfacing, patients may be at greater risk of impingement, leading to abnormal wear patterns and pain. We assessed femoral head/neck offset in 63 hips undergoing metal-on-metal hip resurfacing and in 56 hips presenting with non-arthritic pain secondary to femoroacetabular impingement. Most hips undergoing resurfacing (57%; 36) had an offset ratio ≤ 0.15 pre-operatively and required greater correction of offset at operation than the rest of the group. In the non-arthritic hips the mean offset ratio was 0.137 (0.04 to 0.23), with the offset ratio correlating negatively to an increasing {alpha} angle. An offset ratio ≤ 0.15 had a 9.5-fold increased relative risk of having an {alpha} angle ≥ 50.5°. Most hips undergoing resurfacing have an abnormal femoral head/neck offset, which is best assessed in the sagittal plane.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General