Clinical advantages with large diameter heads

  • N. Santori
  • R. Giacomi
  • D. Potestio
  • F. Chilelli
Conference paper
Part of the Ceramics in Orthopaedics book series (CIO)


A larger femoral head with a last generation ceramic on ceramic or metal on metal coupling is an useful recent introduction in THR. Most of the clinical advantages reported with the use of hip resurfacing (increased stability, improved ROM and lower dislocation rate) can be reproduced with large diameter joints and a conventional femoral implant. Some concerns still remains on the potential ions release by metal on metal in the long term.

At the present time, not all patients in our practise receive large diameter THR. Restriction of the use of these devices is mostly influenced by the high cost of these components. It is possible that, in the future, large diameter, either metal on metal or ceramic on ceramic, will completely replace the conventional 28mm THR.


Femoral Head Large Diameter Femoral Neck Fracture Acetabular Component Metal Coupling 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Phillips C, Barrett J, Losina E, et al: Incidence Rates of Dislocation, Pulmonary Embolism, and Deep Infection During the first six months after Elective Total Hip Replacement. Journal of Bone and Joint Surgery 85-A:20–26, 2003.PubMedGoogle Scholar
  2. 2.
    Beaule P, Schmalzried T, Udomkiat P, Amstutz H: Jumbo Femoral Head for the Treatment of Recurrent Dislocation Following Total Hip Replacement. Journal of Bone and Joint Surgery 84-A:256–263, 2002.PubMedGoogle Scholar
  3. 3.
    Kelley SS, Lachiewicz PF, Hickman JM, Paterno SM: Relationship of Femoral Head and Acetabular Size to the Prevalence of Dislocation. Clin.Orthop. 355:163–170, 1998.PubMedCrossRefGoogle Scholar
  4. 4.
    D’Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW Jr. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am,; 82: 315–21, 2000.PubMedGoogle Scholar
  5. 5.
    Barrack RL, Butler RA, Laster DR, Andrews P. Stem design and dislocation after revision total hip arthroplasty: clinical results and computer modeling. J Arthoplasty, 16(8 Suppl 1):8–12, 2001.CrossRefGoogle Scholar
  6. 6.
    Grecula MJ, Grigoris P, Schmalzried TP, Dorey F, Campbell PA, Endoprostheses for osteonecrosis of the femoral head. A comparison of four models in young patients. Int Orthop. 19(3):137–43, 1995.PubMedCrossRefGoogle Scholar
  7. 7.
    Hedlundh U, Ahnfelt L, Hybbinette CH, Wallinder L, Weckstrom J, Fredin H. Dislocations and the femoral head size in primary total hip arthroplasty. Clin Orthop Relat Res. 333:226–33, 1996.PubMedCrossRefGoogle Scholar
  8. 8.
    Amstutz, H.C. Kody, MH: Dislocation and Subluxation. In Amstutz HC (ed). Hip Arthroplasty. New York, Churchill Livingstone. 429–448, 1991.Google Scholar
  9. 9.
    Bader R, Scholz R, Steinhauser E, Zimmermann S, Busch R, Mittelmeier W. The influence of head and neck geometry on stability of total hip replacement A mechanical test study. Acta Orthop Scand; 75(4): 415–421 415, 2004.PubMedCrossRefGoogle Scholar
  10. 10.
    Kelley SS, Lachiewicz PF, Hickman JM, Paterno SM. Relationship of femoral head and acetabular size to the prevalence of dislocation. Clin Orthop Relat Res. 355:163–70, 1998.PubMedCrossRefGoogle Scholar
  11. 11.
    Beaulé PE et al.: Metal-on-metal surface arthroplasty with a cemented femoral component: A 7–10 year follow-up study. J Arthroplasty 19, Suppl 3: 17–22, 2004.Google Scholar
  12. 12.
    Campbell JH, Beaulé PE.: Editorial, J Arthroplasty 19, Suppl 3: 2–3, 2004.Google Scholar
  13. 13.
    Shimmin AJ, Back D.: Femoral neck fractures following Birmingham hip resurfacing. a national review of 50 cases. JBJS;87-B:463–464, 2005.Google Scholar
  14. 14.
    Von Knoch M, Berry D: Late Dislocation after Total Hip Arthroplasty. JBJS 84-A:1949–1953, 2002.Google Scholar
  15. 15.
    Mulholland SJ, Wyss UP. Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res. Sep;24(3):191–8, 2001.PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag, Darmstadt 2006

Authors and Affiliations

  • N. Santori
  • R. Giacomi
  • D. Potestio
  • F. Chilelli

There are no affiliations available

Personalised recommendations