Skip to main content
SpringerLink
Log in

Do large femoral heads reduce the risks of impingement in total hip arthroplasty with optimal and non-optimal cup positioning?

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

The purpose of this study was to assess whether large femoral heads (36–38 mm) improve the range of motion in total hip arthroplasty compared to standard (28–32 mm) femoral heads in the presence of optimal and non-optimal cup positioning. A mathematical model of the hip joint was generated by using a laser scan of a dried cadaveric hip. The range of motion was assessed with a cup inclination and anteversion of reference and with non-optimal cup positions. Large femoral heads increased the range of motion, compared to the 28-mm femoral head, in the presence of a hip prosthesis correctly implanted and even more so in the presence of non-optimal cup positioning. However, with respect to the 32-mm femoral head, large femoral heads showed limited benefits both in the presence of optimal and non-optimal cup positioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Berry DJ, von Knoch M, Schleck CD, Harmsen WS (2005) Effect of femoral head diameter and operative approach on risk of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am 87:2456–2463

    Article  PubMed  Google Scholar 

  2. Kelley SS, Lachiewicz PF, Hickman JM, Paterno SM (1998) Relationship of femoral head and acetabular size to the prevalence of dislocation. Clin Orthop Relat Res 355:163–170

    Article  PubMed  Google Scholar 

  3. Alberton GM, High WA, Morrey BF (2002) Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg Am 84:1788–1792

    PubMed  Google Scholar 

  4. Burroughs BR, Hallstrom B, Golladay GJ et al (2005) Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes. An in vitro study. J Arthroplasty 20:11–19

    Article  PubMed  Google Scholar 

  5. Peters CL, McPherson E, Jackson JD, Erickson A (2007) Reduction in early dislocation rate with large-diameter heads in primary total hip arthroplasty. J Arthroplasty 22:140–144

    Article  PubMed  Google Scholar 

  6. Johnston RC, Smidt GL (1970) Hip motion measurements for selected activities of daily living. Clin Orthop Relat Res 72:205–215

    PubMed  CAS  Google Scholar 

  7. Kelley SS, Lachiewicz PF, Hickman JM, Paterno SM (1998) Relationship of femoral head and acetabular size to the prevalence of dislocation. Clin Orthop Relat Res 355:163–170

    Article  PubMed  Google Scholar 

  8. Beaulé PE, Schmalzried TP, Udomkiat P, Amstutz HC (2002) Jumbo femoral head for the treatment of recurrent dislocation following total hip replacement. J Bone J Surg Am 84(2):256–263

    Google Scholar 

  9. Lachiewicz PF, Soileau ES (2006) Dislocation of primary total hip arthroplasty with 36- and 40-mm femoral heads. Clin Orthop Relat Res 453:153–155

    Article  PubMed  Google Scholar 

  10. Dorr LD, Wolf AW, Chandler R, Conaty JP (1983) Classification and treatment of dislocations of total hip arthroplasty. Clin Orthop Relat Res 173:151–158

    PubMed  Google Scholar 

  11. McCollum DE, Gray WJ (1990) Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res 261:159–170

    PubMed  Google Scholar 

  12. Ritter MA (1976) Dislocation and subluxation of the total hip replacement. Clin Orthop Relat Res 121:92–94

    PubMed  Google Scholar 

  13. Woo RY, Morrey BF (1982) Dislocations after total hip arthroplasty. J Bone Joint Surg Am 64:1295–1306

    PubMed  CAS  Google Scholar 

  14. Matsushita I, Morita Y, Ito Y, Gejo R, Kimura T (2009) Activities of daily living after total hip arthroplasty. Is a 32-mm femoral head superior to a 26-mm head for improving daily activities? Int Orthop. doi:10.1007/s00264-009-0909-8

  15. D’Lima DD, Urouhart AG, Buehhler KO et al (2000) The effect of the orientation of the acetabular and femoral component on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am 83:315–321

    Google Scholar 

  16. Bartz R, Noble PC, Kadakia NR, Tullos HS (2000) The effect of femoral component head size on posterior dislocation of the artificial hip joint. J Bone J Surg Am 82:1300–1307

    CAS  Google Scholar 

  17. Widemar K-H (2007) Containment versus impingement: finding a compromise for cup placement in total hip arthroplasty. Int Orthop 31(Suppl 1):S29–S33

    Article  Google Scholar 

  18. Crowninshield RD, Maloney WJ, Wentz DH et al (2004) Biomechanics of large femoral heads. Clin Orthop Rel Res 429:102–107

    Article  Google Scholar 

  19. Usrey MM, Noble PC, Rudner LJ, Conditt MA, Birman MV, Santore RF, Mathis KB (2006) Does neck/liner impingement increase wear of ultrahigh-molecular-weight polyethylene liners? J Arthroplasty 21(6 Suppl 2):65–71

    Article  PubMed  Google Scholar 

  20. Yamaguchi M, Akisue T, Bauer TW, Hashimoto Y (2000) The spatial location of impingement in total hip arthroplasty. J Arthroplasty 15:305–313

    Article  PubMed  CAS  Google Scholar 

  21. Barrack RL, Butler RA, Laster DR, Andrews P (2001) Stem design and dislocation after revision total hip arthroplasty: clinical results and computer modeling. J Arthroplasty 16(8 Suppl 1):8–12

    Article  PubMed  CAS  Google Scholar 

  22. Earll M, Fehring T, Griffin WL, Mason JB, McCoy TH (2004) Early osteolysis associated with trunion-liner impingement. Clin Orthop Relat Res 418:153–156

    Article  PubMed  Google Scholar 

  23. Padgett DE, Lipman J, Robie B, Nestor BJ (2006) Influence of total hip design on dislocation: a computer model and clinical analysis. Clin Orthop Relat Res 447:48–52

    Article  PubMed  Google Scholar 

  24. Murray DW (1992) Impingement and loosening of the long posterior wall acetabular implant. J Bone Joint Surg Br 74:377–379

    PubMed  CAS  Google Scholar 

  25. Cobb TK, Morrey BF, Ilstrup DM (1996) The elevated-rim acetabular liner in total hip arthroplasty: relationship to postoperative dislocation. J Bone Joint Surg Am 78:80–86

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department, University La Sapienza, Rome, Italy

    Gianluca Cinotti & Niccolò Lucioli

  2. DTM Technologies, Modena, Italy

    Andrea Malagoli, Carlo Calderoli & Ferdinando Cassese

Authors
  1. Gianluca Cinotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niccolò Lucioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Malagoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlo Calderoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ferdinando Cassese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gianluca Cinotti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cinotti, G., Lucioli, N., Malagoli, A. et al. Do large femoral heads reduce the risks of impingement in total hip arthroplasty with optimal and non-optimal cup positioning?. International Orthopaedics (SICOT) 35, 317–323 (2011). https://doi.org/10.1007/s00264-010-0954-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-010-0954-3

Keywords

Search

Navigation