Journal
JOURNAL OF ARTHROPLASTY
Volume 23, Issue 7, Pages 1074-1079Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2007.09.011
Keywords
hip resurfacing; hip impingement; femoral head-neck offset; femoral head-neck diameter ratio; femoral neck osteoplasty
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Many patients undergoing, total hip resurfacing arthroplasty present with reduced anterior femoral neck concavity as a part of the degenerative process. Painful hip impingement may develop or persist after hip resurfacing when the retained femoral neck abuts against the metallic acetabular component or the anterior acetabular bony wall. We report on two cases of painful postoperative hip impingement after hip resurfacing, in one of whom anterior neck-contouring osteoplasty restored pain-free range of motion (ROM). To restore natural hip ROM, surgeons performing hip total hip resurfacing arthroplasty should aim to reproduce the normal femoral head-neck offset ratio. Femoral head-neck offset restoration can be achieved by proper femoral component positioning (especially optimal translation), by femoral neck osteoplasty or by increasing femoral component head size appropriately.
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