The Journal of Arthroplasty
Volume 23, Issue 7 , Pages 1074-1079, October 2008

Painful Impingement of the Hip Joint After Total Hip Resurfacing: A Report of Two Cases

  • Martin Lavigne, MD, MSc, FRCS

      Affiliations

    • Department of Surgery, Université de Montréal, Montréal, Québec, Canada
    • Department of Surgery, Université de Montréal, Montréal, Québec, Canada
    • Corresponding Author InformationReprint requests: Martin Lavigne, MD, FRCS, 5345, boul. de l'Assomption, suite 55, Montréal, Québec, Canada H1T 4B3.
  • ,
  • Krishna R. Boddu Siva Rama, MS, MRCS

      Affiliations

    • Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
  • ,
  • Alain Roy, MD, FRCS

      Affiliations

    • Department of Surgery, Université de Montréal, Montréal, Québec, Canada
    • Department of Surgery, Université de Montréal, Montréal, Québec, Canada
  • ,
  • Pascal-André Vendittoli, MD, MSc, FRCS

      Affiliations

    • Department of Surgery, Université de Montréal, Montréal, Québec, Canada
    • Department of Surgery, Université de Montréal, Montréal, Québec, Canada

Received 12 September 2006; accepted 6 September 2007. published online 25 January 2008.

Abstract 

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.

Key words: hip resurfacing, hip impingement, femoral head-neck offset, femoral head-neck diameter ratio, femoral neck osteoplasty

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 No benefits or funds were received in support of the study.

PII: S0883-5403(07)00549-9

doi:10.1016/j.arth.2007.09.011

The Journal of Arthroplasty
Volume 23, Issue 7 , Pages 1074-1079, October 2008