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Should We Worry About Periacetabular Interference Gaps in Hip Resurfacing?

  • Symposium: Papers Presented at the Annual Meetings of The Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Press-fit acetabular component seating in hip resurfacing can be challenging as a strong interference fit is required. It has not been established whether reducing the acetabular underream minimizes incomplete component seating or leads to increased acetabular loosening.

Questions/purposes

We examined (1) the incidence and natural history of postoperative interference gaps in hip resurfacing and (2) whether reduction of the acetabular underream from 2 mm to 1 mm reduces the incidence of periacetabular interference gaps.

Methods

Of 327 Birmingham Hip™ Resurfacings (Smith & Nephew Inc, Memphis, TN, USA) performed by a single surgeon from 2005 to 2010, we evaluated 306 hips with a minimum 1-year radiographic followup. Postoperative periacetabular interference gaps were monitored for radiographic gap resolution at latest followup. The frequency of incomplete component seating was compared between acetabula prepared with 1- and 2-mm underream techniques. Minimum followup was 1 year (mean, 2.7 years; range, 1–6 years).

Results

Fifty-one percent of the postoperative radiographs demonstrated the presence of a periacetabular interference gap. At latest followup, 96% of these gaps were no longer visible. We observed a reduction in the number of interference gaps identified when acetabular preparation changed from a 2-mm underream (63%) to a 1-mm underream (39%). There were no revisions due to acetabular failure.

Conclusions

Periacetabular interference gaps were common in this series but not associated with acetabular component failure. The use of a 1-mm underream is sufficient for adequate short-term press-fit fixation of the acetabular component in Birmingham Hip™ Resurfacing arthroplasty.

Level of Evidence

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

The authors would like to thank Zachary Morison, MSc, for the preparation of the imaging used by the observers in the study and tabulation of the data.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgery, St Michael’s Hospital, Room 800, 55 Queen Street East, Toronto, ON, M5C1R6, Canada

    Bruno Gomes MBBS, FRACS(Orth), Michael Donnelly MD, MCh, FRCS(Tr&Orth), Ashesh Kumar MD, FRCS(C) & Emil H. Schemitsch MD, FRCS(C)

  2. Martin Orthopaedic Biomechanics Laboratory, St Michael’s Hospital, University of Toronto, Li Ka Shing Knowledge Institute, Toronto, ON, Canada

    Michael Olsen PhD

Authors
  1. Bruno Gomes MBBS, FRACS(Orth)
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  2. Michael Olsen PhD
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  3. Michael Donnelly MD, MCh, FRCS(Tr&Orth)
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  4. Ashesh Kumar MD, FRCS(C)
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  5. Emil H. Schemitsch MD, FRCS(C)
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Corresponding author

Correspondence to Emil H. Schemitsch MD, FRCS(C).

Additional information

One or more of the authors (EHS) has received or may receive payments or benefits, in any 1 year, an amount in excess of $10,000 from a commercial entity (Smith & Nephew Inc, Memphis, TN, USA) related to this work.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

Each 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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Gomes, B., Olsen, M., Donnelly, M. et al. Should We Worry About Periacetabular Interference Gaps in Hip Resurfacing?. Clin Orthop Relat Res 471, 422–429 (2013). https://doi.org/10.1007/s11999-012-2665-0

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  • DOI: https://doi.org/10.1007/s11999-012-2665-0

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