Clinical Orthopaedics and Related Research®

, Volume 472, Issue 2, pp 572–576 | Cite as

Do Jumbo Cups Cause Hip Center Elevation in Revision THA? A Computer Simulation

  • Chima Nwankwo
  • Nick N. Dong
  • Christopher D. Heffernan
  • Michael D. Ries
Symposium: 2013 Hip Society Proceedings

Abstract

Background

Acetabular revision THA with use of a large (jumbo) cup is an effective treatment for many cavitary and segmental peripheral bone defects. However, the jumbo cup may result in elevation of the hip center and protrusion through the anterior acetabular wall as a result of the oversized geometry of the jumbo cup compared with the physiologic acetabulum.

Questions/purposes

The purpose of this computer simulation was to determine how much elevation of the hip center and anterior wall protrusion occurs in revision THA with use of a jumbo cup technique in which the inferior edge of the jumbo cup is placed at the inferior acetabular rim and the superior edge of the jumbo cup is placed against host bone at the superior margin of a posterosuperior bone defect.

Methods

Two hundred sixty-five pelvic CT scans were analyzed by custom CT analytical software. The computer simulated oversized reaming. The vertical and anterior reamer center shifts were measured, and anterior column bone removal was determined.

Results

The computer simulation demonstrated that the hip center shifted 0.27 mm superiorly and 0.02 mm anteriorly, and anterior column bone removal increased 0.86 mm for every 1-mm increase in reamer diameter.

Conclusions

Our results indicate that the jumbo cup technique results in hip center elevation despite placement of the cup adjacent to the inferior acetabulum. For a hypothetical increase from a 54-mm socket to a 72-mm socket, as one might see in the context of the revision of a failed THA, our model would predict an elevation of the hip center of approximately 5 mm and loss of approximately 15 mm of anterior column bone. This suggests that an increase in femoral head length may be needed to compensate for the hip center elevation caused by the use of a large jumbo cup in revision THA. A jumbo cup may also result in protrusion through the anterior wall.

Keywords

Acetabular Revision Posterior Acetabular Wall Acetabular Margin Bulk Allograft Acetabular Anatomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Chima Nwankwo
    • 1
  • Nick N. Dong
    • 2
  • Christopher D. Heffernan
    • 2
  • Michael D. Ries
    • 1
    • 3
  1. 1.Department of Orthopaedic SurgeryUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Stryker Orthopaedics, IncMahwahUSA
  3. 3.Tahoe Fracture and Orthopaedic ClinicCarson CityUSA

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