Case Report| Volume 27, ISSUE 8, P1580.e9-1580.e11, September 2012

Posterior Femoral Neck Impingement Secondary to Excess Acetabular Anteversion in Hip Resurfacing Arthroplasty


      Component malposition in resurfacing arthroplasty can cause impingement, reduced range of motion, increased metal wear, and early failure. It is therefore important that any component malposition is recognized early and monitored carefully. We present a case of delayed diagnosis of excess acetabular component anteversion causing posterior femoral neck impingement and pain. We correlate the degree of damage found intraoperatively with the degree of component malposition on the radiographs. This is used as a platform to discuss the optimum positioning of hip resurfacing components and the radiographic methods used to determine component position postoperatively.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Arthroplasty
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • McMinn D.
        • Daniel J.
        History and modern concepts in surface replacement.
        Proc Inst Mech Eng H. 2006; 220: 239
        • Shimmin A.J.
        • Bare J.
        • Back D.L.
        Complications associated with hip resurfacing arthroplasty.
        Orthop Clin North Am. 2005; 36 (ix): 187
        • Willert H.G.
        • Buchhorn G.H.
        • Fayyazi A.
        • et al.
        Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study.
        J Bone Joint Surg Am. 2005; 87: 28
        • Malik A.
        • Maheshwari A.
        • Dorr L.D.
        Impingement with total hip replacement.
        J Bone Joint Surg Am. 2007; 89: 1832
        • Mian S.W.
        • Truchly G.
        • Pflum F.A.
        Computed tomography measurement of acetabular cup anteversion and retroversion in total hip arthroplasty.
        Clin Orthop Relat Res. 1992; : 206
        • Williams D.
        • Royle M.
        • Norton M.
        Metal-on-metal hip resurfacing: the effect of cup position and component size on range of motion to impingement.
        J Arthroplasty. 2009; 24: 144
        • McMinn D.
        • Daniel J.
        • Pradhan C.
        • et al.
        10-year results of modern hip resurfacing: hip function, clinico-radiological and CT scan assessment, #P098 - American Academy of Orthopaedic Surgeons. Las Vegas. 2009
        • Grammatopoulos G.
        • Pandit H.
        • Glyn-Jones S.
        • et al.
        Optimal acetabular orientation for hip resurfacing.
        J Bone Joint Surg Br. 2010; 92: 1072
        • Murray D.W.
        The definition and measurement of acetabular orientation.
        J Bone Joint Surg Br. 1993; 75: 228
        • Lewinnek G.E.
        • Lewis J.L.
        • Tarr R.
        • et al.
        Dislocations after total hip-replacement arthroplasties.
        J Bone Joint Surg Am. 1978; 60: 217
        • Langton D.J.
        • Sprowson A.P.
        • Mahadeva D.
        • et al.
        Cup anteversion in hip resurfacing: validation of EBRA and the presentation of a simple clinical grading system.
        J Arthroplasty. 2010; 25: 607
        • Kalteis T.
        • Handel M.
        • Herold T.
        • et al.
        Position of the acetabular cup—accuracy of radiographic calculation compared to CT-based measurement.
        Eur J Radiol. 2006; 58: 294
        • Eddine T.A.
        • Migaud H.
        • Chantelot C.
        • et al.
        Variations of pelvic anteversion in the lying and standing positions: analysis of 24 control subjects and implications for CT measurement of position of a prosthetic cup.
        Surg Radiol Anat. 2001; 23: 105