Acetabular Bone Loss by Dr....

Acetabular Bone Loss by Dr. Vijay C. Bose

 

...The acetabular size is the most important factor which determines the choice of femoral head size in resurfacing and one never removes more acetabular bone in hip resurfacings. In other words if I would be performing a conventional hip replacement on a given patient instead of resurfacing, I would be using precisely the same size acetabular component in both the surgeries.

 

I would go as far as saying that if we are taking out more acetabular bone in resurfacing than in conventional hip replacement , then in my opinion there is no role for resurfacing and it must be discontinued immediately. Acetabular conservation is as important if not more than femoral bone conservation and all resurfacing surgeons recognize and acknowledge this fact. The ability to put large heads in resurfacing stems from the fact that thin shelled acetabular components are possible with the modern metal on metal bearings. However when one uses polyethylene it has to have a large thickness ,which in turn reduces the femoral head diameter , (assuming the acetabular outer shell diameter remains the same). The same argument holds true for ceramic on ceramic bearing to a lesser extent and therefore slightly large femoral head sizes than metal on poly is possible. However an anatomical size is currently possible only with metal on metal bearings...

 

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