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IS A LARGE METAL ON METAL BEARING WITH A CONVENTIONAL FEMORAL STEM MORE CONSERVATIVE OF ACETABULAR BONE THAN HIP RESURFACING?



Abstract

Introduction: Disagreement exists in the literature as to whether hip resurfacing requires more acetabular reaming than uncemented hip replacement.

Materials and Methods: Thirty-nine patients underwent total hip arthroplasty with a large metal on metal resurfacing acetabular cup and large metal head with a conventional uncemented femoral stem. Although there was no change in routine operative technique the femoral neck was measured (as if for resurfacing) before being cut. The size of the acetabular component actually inserted was compared with the smallest size which could have been used had a resurfacing been carried out for each patient. A two tailed paired t test was carried out.

Results: We found that there was no difference in female patients but in men the actual cup used was 2.44mm smaller than the smallest possible resurfacing cup which equates to 6.39cm3 less bone (p < 0.0001).

Discussion: By using paired samples we have reduced confounding factors and shown that a large metal on metal bearing on a conventional stem is more conservative of acetabular bone than hip resurfacing in male patients.

Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org