Impingement Between the Acetabular Cup and the Femoral Neck After Hip Resurfacing Arthroplasty

Myung Chul Yoo; Yoon Je Cho; Young Soo Chun; Kee Hyung Rhyu
May 2011
Journal of Bone & Joint Surgery, American Volume;5/4/2011 Supplement, Vol. 93-A, p99
Academic Journal
Background: Loosening, femoral neck fracture, and metal ion release have been well documented after hip resurfacing arthroplasty, but impingement between the acetabular cup and the femoral neck has not. The goal of this study was to analyze radiographic findings that were presumed to represent impingement of the neck after hip resurfacing arthroplasty, and to describe the mechanism of impingement. Methods: Of the 635 hips (579 patients) that underwent hip resurfacing arthroplasty between September 1998 and May 2008, forty hips (6.3%) with positive radiographic findings were available for this study. The mean age of the patients was 34.9 years and there were thirty-five men and five women. The average follow-up was sixty-eight months (twenty-four to 132 months). Radiographic evaluation included an analysis of neck-shaft angle, inclination of the acetabular cup, headneck ratio, lateral protrusion of the cup, anterior protrusion of the cup, and stem angle to the axis of the femoral neck. Results: Impingement between the acetabular cup and the femoral neck occurred in 6.3% of hips and appeared at an average of seven months after surgery. There was no further change two years postoperatively. The impingement findings did not correlate with the clinical outcome, but all instances of impingement were located in the lateral or anterolateral part of the femoral neck along the arc from the center of the femoral head to the lateral edge of the socket. No significant factors were found to be related to the occurrence of impingement. Conclusions: Femoral-neck impingement should be differentiated from notching, narrowing, stress-shielding, or osteolysis of the femoral neck. Although we found no significant factors to explain the impingement found in the hips in our study, it appears that repetitive extreme motion of the involved hip and malposition of the implants can cause impingement after hip resurfacing arthroplasty. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • A Survey on the Prevalence of Pseudotumors with Metal-on-Metal Hip Resurfacing in Canadian Academic Centers. Beaulé, Paul E. // Journal of Bone & Joint Surgery, American Volume;5/4/2011 Supplement, Vol. 93-A, p118 

    Background: Metal-on-metal bearings for hip arthroplasty have been in clinical use for over twenty years with excellent clinical results reported worldwide. A small percentage (<1%) of patients have developed an inflammatory response, and a more severe inflammatory response termed pseudotumor...

  • Comparative Epidemiology of Revision Arthroplasty: Failed THA Poses Greater Clinical and Economic Burdens Than Failed TKA. Bozic, Kevin; Kamath, Atul; Ong, Kevin; Lau, Edmund; Kurtz, Steve; Chan, Vanessa; Vail, Thomas; Rubash, Harry; Berry, Daniel // Clinical Orthopaedics & Related Research;Jun2015, Vol. 473 Issue 6, p2131 

    Background: Revision THA and TKA are growing and important clinical and economic challenges. Healthcare systems tend to combine revision joint replacement procedures into a single service line, and differences between revision THA and revision TKA remain incompletely characterized. These...

  • Evolution in Hip Resurfacing Design and Contemporary Experience with an Uncemented Device. Spencer, Robert F. // Journal of Bone & Joint Surgery, American Volume;5/4/2011 Supplement, Vol. 93-A, p84 

    The concepts of surface replacement of the hip and metal-on-metal articulation date back to the 1930s, and recent hip resurfacing designs have been more successful than their predecessors. Experience with the Cormet device followed initial collaboration with Mr. Derek McMinn. Both hybrid...

  • Residual Groin Pain at a Minimum of Two Years After Metal-on-Metal THA with a Twenty-eight-Millimeter Femoral Head, THA with a Large-Diameter Femoral Head, and Hip Resurfacing. Lavigne, Martin; Laffosse, Jean-Michel; Ganapathi, Muthu; Girard, Julien; Vendittoli, Pascal // Journal of Bone & Joint Surgery, American Volume;5/4/2011 Supplement, Vol. 93-A, p93 

    Background: Groin pain may persist in up to 4.3% of patients after total hip arthroplasty and up to 18% of patients one year after hip resurfacing. The incidence of this problem after total hip arthroplasty with a large-diameter femoral head is unknown. Methods: We analyzed the natural history...

  • Revision Total Hip Arthroplasty Performed Through the Hueter Interval. Mast, Nicholas H.; Laude, Frédéric // Journal of Bone & Joint Surgery, American Volume;5/4/2011 Supplement, Vol. 93-A, p143 

    Revision total hip arthroplasty through the direct anterior approach is technically challenging but offers some advantages in exposure of the acetabulum. This study presents a retrospectively reviewed consecutive series of fifty-one patients who underwent revision total hip arthroplasty through...

  • Fixation, Survival, and Dislocation of Jumbo Acetabular Components in Revision Hip Arthroplasty. Lachiewicz, Paul F.; Soileau, Elizabeth S. // Journal of Bone & Joint Surgery, American Volume;3/20/2013, Vol. 95-A Issue 6, p543 

    Background: Acetabular revision of a total hip arthroplasty using jumbo components (Mayo definition, ≥62 mm in women and ≥66 mm in men) offers distinct advantages in patients with notable acetabular bone loss. However, there are little data on the long-term survival and complications...

  • Accuracy of Acetabular Component Position in Hip Arthroplasty. Barrack, Robert L.; Krempec, Jeffrey A.; Clohisy, John C.; McDonald, Douglas J.; Ricci, William M.; Ruh, Erin L.; Nunley, Ryan M. // Journal of Bone & Joint Surgery, American Volume;10/2/2013, Vol. 95-A Issue 19, p1760 

    Background: Acetabular component malposition is linked to higher bearing surface wear and component instability. Outcomes following total hip arthroplasty and surface replacement arthroplasty depend on multiple surgeon and patient-dependent factors. The purpose of this study was to examine the...

  • Factors affecting the osteolysis around the components after posterior-stabilized total knee replacement arthroplasty. Kim, Chang; Seo, Seung; Kim, Jung; Lee, Hyeong; Lee, Chang // Knee Surgery, Sports Traumatology, Arthroscopy;Jun2015, Vol. 23 Issue 6, p1863 

    Purpose: The purpose of the present study was to evaluate factors that affect the occurrence of osteolysis through clinical and radiological comparison between a patient group in which osteolysis occurred after total knee arthroplasty (TKA) and a patient group in which osteolysis did not occur...

  • Increased Risk of Periprosthetic Femur Fractures Associated With a Unique Cementless Stem Design. Watts, Chad; Abdel, Matthew; Lewallen, David; Berry, Daniel; Hanssen, Arlen // Clinical Orthopaedics & Related Research;Jun2015, Vol. 473 Issue 6, p2045 

    Background: Postoperative periprosthetic femur fractures are an increasing concern after primary total hip arthroplasty (THA). Identifying and understanding predisposing factors are important to mitigating future risk. Femoral stem design may be one such factor. Questions/purposes: The goals of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics