Jumbo Acetabular Cup in the Indian Population: Is It Time to Reconsider Existing Thresholds?

The definition of jumbo acetabular cups for revision total hip arthroplasty (THA) is predominantly based on Western populations, with limited applicability to ethnic variations. Indian patients often exhibit distinct anatomical characteristics, necessitating population-specific guidelines to avoid complications such as excessive bone loss or suboptimal component fixation. This study aimed to establish jumbo cup dimensions for Indian patients and compare these findings with global standards.

This retrospective, multicenter observational study analyzed data from 2,372 primary THA patients across four high-volume orthopedic centers in India (2010-2023). Patient demographics, etiology, and acetabular component sizes were extracted from institutional registries. The jumbo cup was defined as 10 mm larger than the mean acetabular component size. Statistical analyses, including one-way ANOVA and linear regression, were conducted to assess the influence of demographic and etiological factors on cup size.

The mean acetabular cup size was 49.99 mm (SD: 3.51). Male patients required significantly larger components (mean: 51.23 mm) compared to females (mean: 47.21 mm, p < 0.001). Based on the jumbo cup definition, thresholds were proposed as 62 mm for men and 58 mm for women. These dimensions are 2-4 mm smaller than those recommended for Western populations. Etiology-specific differences were observed, with post-acetabular fractures requiring the largest cups (mean: 2.08 mm increase, p < 0.001).

This study highlights the need for ethnic-specific jumbo cup definitions in revision THA. The proposed dimensions for Indian patients provide a practical framework for preoperative planning, emphasizing the importance of personalized surgical strategies to enhance outcomes and reduce complications.