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IS SURFACE REPLACEMENT A BONE CONSERVING PROCEDURE ON THE ACETABULAR BONE STOCK? – AN ANALYSIS OF 257 CONSECUTIVE SURFACE REPLACEMENTS AND 458 PRIMARY HYBRID TOTAL HIP REPLACEMENTS



Abstract

Hip resurfacing is widely recognised as a bone conserving procedure with respect to proximal femoral resection. However, it has been argued that this is not the case for the acetabulum due to the thickness of the acetabular component and the large diameter bearing surfaces. We have investigated whether the Birmingham Hip is a bone conserving procedure with respect to the acetabular bone stock.

Data was obtained from 257 consecutive Midland Medical Technology (MMT) surface replacements and 458 primary hybrid total hip replacements implanted under our care. The surface replacement group comprised 185 males (185 hips) and 72 females (72 hips) with a mean age at surgery of 55 years. The hybrid primary total hip replacement group comprised 207 males (207) and 251 females (251 hips). The mean age at surgery was 65 years old. In the surface replacement group the mean uncemented acetabular size implanted was 54.88 mm (females = 51.9 mm; males = 57.8 mm). In the hybrid primary total hip replacement group the mean uncemented acetabular size of 55.04 mm (females =52.9 mm; males = 57.2 mm).

Statistical analysis was undertaken to compare the uncemented acetabular sizes in the surface replacement group with the uncemented acetabular sizes implanted in the primary hybrid total hip replacement group. We report no significant difference in the size of acetabular component used for the two groups (p = 0.4629; 95% C.I. −0.28 to 0.61). The effect of gender was analysed and the mean size of uncemented acetabular component implanted in males for the surface replacement group was not significantly different (p = 0.06) to the hybrid primary total hip replacement group. However the mean size of uncemented acetabular component in females for the surface replacement group was significantly smaller (p = 0.016) compared to the primary total hip replacement group.

We conclude hip resurfacing is not bone sacrificing on the acetabular bone stock and can be bone conserving for females.

The abstracts were prepared by Nico Verdoschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, Universitair Medisch Centrum, Orthopaedie / CSS1, Huispost 800, Postbus 9101, 6500 HB Nijmegen, Th. Craanenlaan 7, 6525 GH Nijmegen, The Netherlands.