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Updated: Jun 26, 2026

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Does hip resurfacing require larger acetabular cups than conventional THA?

Florian D Naal1, Michael S H Kain, Otmar Hersche

  • 1Department of Orthopaedic Surgery, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland. florian.naal@gmail.com

Clinical Orthopaedics and Related Research
|January 15, 2009
PubMed
Summary

Hip resurfacing implants generally use larger acetabular cup sizes compared to conventional total hip arthroplasty (THA). Patient height influences cup size, but cup positioning does not. Further research is needed for long-term clinical implications.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Implant design

Background:

  • Hip resurfacing arthroplasty (HRA) preserves femoral bone, but acetabular bone removal remains a concern.
  • Controversy exists regarding the extent of bone resection at the acetabular side during HRA.

Purpose of the Study:

  • To compare implanted acetabular cup sizes between two hip resurfacing devices and a conventional press-fit total hip arthroplasty (THA).
  • To assess the influence of patient demographics and cup position on acetabular component size.

Main Methods:

  • Retrospective analysis of 2134 primary THA cases.
  • Comparison of Allofit cup (1643 hips), Durom Hip Resurfacing (249 hips), and Birmingham Hip Resurfacing (242 hips) against conventional press-fit cups.
  • Patient demographics (gender, height, weight, BMI, age) and cup position were analyzed after matching.

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Main Results:

  • Hip resurfacing devices (Durom and Birmingham) used larger mean acetabular cup sizes than the Allofit cup in both women and men.
  • Larger cups were implanted with hip resurfacing compared to conventional press-fit THA.
  • Patient height was associated with implanted cup size, while horizontal plane cup position had no effect.

Conclusions:

  • Hip resurfacing implants tend to utilize larger acetabular component sizes than conventional THA.
  • The association between patient height and cup size should be considered in future comparative implant studies.
  • Long-term clinical significance of these size differences requires further investigation.