Acetabular bone loss is a matter for concern in hip resurfacing arthroplasty (HRA), as preservation of the femoral head and neck might demand a larger acetabular cup than in total hip arthroplasty (THA). Using radiographic templating, the cup size required for either THA or HRA was calculated on 100 pelvic films. First, the cup size was determined based on the dimensions of the acetabulum. Then, the cup size for HRA was evaluated taking into account the dimensions of the femoral head/neck. The average cup size required for HRA was larger than for THA (delta + 1.1 mm). The cup size for HRA and THA was similar in 49% of hips; in 51% of the hips the cup required for HRA was larger: one size larger in 31%, two sizes larger in 18% and three sizes larger in 2% of the cases. The greatest difference and highest bone loss were observed for the large sizes (between 52 and 56 mm) and thus predominantly in men (delta + 15 mm male, delta + 0.7 mm female). This study shows that HRA requires a larger acetabular cup in more than 50% of the cases compared to THA. When planning HRA surgeons should remember that cup size is determined by the size of the matching femoral component and that size difference with THA increases with increasing hip sizes.

译文

髋臼置换术是髋关节置换术(HRA)值得关注的问题,因为与全髋关节置换术(THA)相比,保存股骨头和颈部可能需要更大的髋臼杯。使用射线照相模板,在100份骨盆底片上计算THA或HRA所需的杯子尺寸。首先,根据髋臼的尺寸确定杯的尺寸。然后,考虑股骨头/颈部的尺寸评估HRA的杯大小。 HRA所需的平均杯子尺寸大于THA(δ1.1毫米)。 HRA和THA的罩杯尺寸在49%的髋部中相似;在51%的臀部中,HRA所需的杯子更大:一种大小的人占31%,两个大小的人占18%,三个大小的人占2%。对于大尺寸(52至56毫米之间),观察到最大的差异和最高的骨损失,因此主要出现在男性中(男性为15毫米,女性为0.7毫米)。这项研究表明,与THA相比,HRA在50%以上的病例中需要更大的髋臼杯。在规划HRA时,外科医生应记住,杯的大小由匹配的股骨组件的大小决定,并且THA的大小差异会随着髋关节大小的增加而增加。

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