A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Surgical Techniques

Background:

• Total hip replacement (THR) and hip resurfacing arthroplasty (HRA) are common procedures for hip joint issues.
• Bone conservation is a critical factor in long-term implant success and revision surgery.
• Acetabular bone preservation during component implantation requires careful consideration.

Purpose of the Study:

• To prospectively compare acetabular bone conservation between THR and HRA.
• To evaluate the impact of implant design and surgical technique on bone removal.
• To determine if HRA offers advantages in acetabular bone preservation compared to THR.

Main Methods:

• Prospective, randomized study involving 210 hips.
• Random assignment to either THR or HRA groups.
• Use of uncemented, press-fit acetabular components in both groups.

Main Results:

• No significant difference in mean acetabular implant diameter between THR (54.74 mm) and HRA (54.90 mm).
• In 6.8% of HRA cases, a larger acetabular component was used to match the femoral component.
• Bone removal on the acetabular side was comparable between the two procedures.

Conclusions:

• Acetabular bone removal can be comparable between THR and HRA.
• Specific acetabular implant designs and meticulous surgical techniques are key to bone conservation in HRA.
• While femoral bone conservation is clear in HRA, acetabular bone preservation is achievable with careful management.