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Do jumbo cups cause hip center elevation in revision THA? A radiographic evaluation.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nwankwo, Chima D. Ries, Michael D.
Description	Country affiliation: United States Author Affiliation: Nwankwo CD ( School of Medicine, University of California, San Francisco, San Francisco, CA, USA.)
Abstract	BACKGROUND: Acetabular revision THA with use of a large (jumbo) cup is an effective treatment for many cavitary and segmental peripheral bone defects. However, hip center elevation may occur with use of a jumbo cup owing to reaming superiorly and/or because of the increased diameter of the jumbo cup compared with the native acetabulum. QUESTIONS/PURPOSES: In our jumbo cup revision THAs, we attempted to avoid hip center elevation by placing the inferior edge of the cup at the inferior acetabulum. In this study, we asked (1) how much of an elevation in the hip center is observed radiographically with use of jumbo cups, and (2) how effective was our technique in minimizing hip center elevation during revision THA in clinical practice? METHODS: We retrospectively reviewed radiographic data for all patients, from one surgeon's practice, who received a jumbo cup (defined as cup size ≥ 66 mm in men, ≥ 62 mm in women) during an acetabular revision between 1998 and 2012 and who had an anatomically placed THA or no THA on the contralateral side (so as to be able to make comparisons); 98 patients were identified and included. The height of the revised hip center was measured relative to the contralateral normal hip. Cup elevation resulting from superior reaming was determined by measuring the distance from the inferior cup edge to the interteardrop line. The mean hip center elevation and cup position relative to the interteardrop line in male and female patients were compared using unpaired t-tests. RESULTS: Radiographic analysis showed a mean hip center elevation of 11 mm. On average, 1 mm of the measured hip center elevation was the result of cup placement superior to its planned position at the interteardop line. CONCLUSIONS: Our results indicate that revision THA with a jumbo cup is associated with hip center elevation despite placement of the cup at the inferior acetabulum. An increase in femoral head length may be needed to compensate for hip center elevation with use of a jumbo cup. LEVEL OF EVIDENCE: Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
File Format	HTM / HTML
ISSN	0009921X
e-ISSN	15281132
DOI	10.1007/s11999-014-3632-8
Journal	Clinical Orthopaedics and Related Researchtextregistered
Issue Number	9
Volume Number	472
Language	English
Publisher	Springer
Publisher Date	2014-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopaedics Acetabulum Arthroplasty, Replacement, Hip Femur Head Hip Joint Hip Prosthesis Postoperative Complications Surgery Prosthesis Design Prosthesis Failure Radiography Reoperation Retrospective Studies
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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