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Title of Journal: Clin Orthop Relat Res

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Abbravation: Clinical Orthopaedics and Related Research®

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Springer US

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1528-1132

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Do Jumbo Cups Cause Hip Center Elevation in Revisi

Authors: Chima Nwankwo Nick N Dong Christopher D Heffernan Michael D Ries
Publish Date: 2013/07/25
Volume: 472, Issue: 2, Pages: 572-576
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Abstract

Acetabular revision THA with use of a large jumbo cup is an effective treatment for many cavitary and segmental peripheral bone defects However the jumbo cup may result in elevation of the hip center and protrusion through the anterior acetabular wall as a result of the oversized geometry of the jumbo cup compared with the physiologic acetabulumThe purpose of this computer simulation was to determine how much elevation of the hip center and anterior wall protrusion occurs in revision THA with use of a jumbo cup technique in which the inferior edge of the jumbo cup is placed at the inferior acetabular rim and the superior edge of the jumbo cup is placed against host bone at the superior margin of a posterosuperior bone defectOur results indicate that the jumbo cup technique results in hip center elevation despite placement of the cup adjacent to the inferior acetabulum For a hypothetical increase from a 54mm socket to a 72mm socket as one might see in the context of the revision of a failed THA our model would predict an elevation of the hip center of approximately 5 mm and loss of approximately 15 mm of anterior column bone This suggests that an increase in femoral head length may be needed to compensate for the hip center elevation caused by the use of a large jumbo cup in revision THA A jumbo cup may also result in protrusion through the anterior wallTwo authors NND CDH are employees of Stryker Orthopaedics Inc Mahwah NJ USA The remaining authors CN MDR certify that he or she or a member of his or her immediate family has no funding or commercial associations eg consultancies stock ownership equity interest patent/licensing arrangements etc that might pose a conflict of interest in connection with the submitted articleEach author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained

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