Abstract
Clinical success of cementless total hip arthroplasty is predicated on proper component
position, restoration of biomechanics, and implantation of a mechanically stable construct.
In the setting of acetabular bone loss, this target is more difficult to achieve,
and elevation of the center of hip rotation may compromise the ability to obtain inferior
screw fixation. We used the LifeMOD virtual human modeling simulation software (Smith
& Nephew, San Clemente, CA) to determine the relationship between cup inclination
and center of rotation position while maintaining the ability to obtain screw fixation
within the superior pubic ramus. This simulation demonstrated that for every 5 mm
of hip center elevation, cup inclination increased by 5.67 degrees. Based on this
data, we recommend the use of a porous acetabular component when the hip center is
elevated. This acetabular reconstruction allows for cementation of a liner to address
the vertical nature of the cup needed to obtain inferior screw fixation within the
superior pubic ramus.
Keywords
revision hip - acetabular reconstruction - acetabular screw fixation
