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Containment versus impingement: finding a compromise for cup placement in total hip arthroplasty

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Abstract

Recommendations for cup containment and impingement may provide conflicting directions for component orientation in total hip arthroplasty. For optimal containment, the cup is positioned with respect to the acetabular bone, resulting in coincidence of the rim of the cup and the acetabulum. This results in good coverage and symmetric load transfer, leading to good long-term stability, but occasionally necessitates more abduction of the cup than that recommended by the safe zone. On the other hand, placement of the cup for an optimal range of motion would lead to only partial containment, with a higher risk of component loosening and revision. The most effective compromise is to use a prosthesis that has a large safe zone, realised by a high head-to-neck ratio, and orienting the cup such that a good containment is achieved and the safe zone is respected. Computer navigation or smart aiming devices may help to find the best relative orientation.

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Authors and Affiliations

  1. Department for Orthopedic Surgery and Traumatology, Kantonsspital Schaffhausen, 8208, Schaffhausen, Switzerland

    K.-H. Widmer

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  1. K.-H. Widmer
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Correspondence to K.-H. Widmer.

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In the preparation of this article, no funding was received in any form whatever. The content of this manuscript is not linked to any product that is commercially available and there are no conflicts of interest directly or indirectly relevant to the contents of this manuscript.

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Widmer, KH. Containment versus impingement: finding a compromise for cup placement in total hip arthroplasty. International Orthopaedics (SICO 31 (Suppl 1), 29–33 (2007). https://doi.org/10.1007/s00264-007-0429-3

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