Factors affecting acetabular bone loss during primary hip arthroplasty - A quantitative analysis using computer simulation.

摘要

BACKGROUND: Although, various factors may affect the degree of acetabular bone loss during primary hip arthroplasty, they have not been quantified previously. METHODS: We assessed the influence of using various reamer diameters, designs and reaming depth on the amount of bone removed during acetabular preparation by simulated reaming in a three-dimensional pelvic model, using computer software. FINDINGS: The least amount of bone loss (6185mm(3)) providing optimal bone contact with the acetabular articular surface occurred with a 165 degrees reamer design. Increase in reamer diameter, reaming depth and subtending angle of the reamer resulted in disproportionately large increase in the amount of bone resected compared to the relatively small increase in the reamer-bone contact area. INTERPRETATION: Surgeons must be aware of the relative influence of the reaming technique and the implant design on the amount of acetabular bone resection to optimize acetabular bone preservation during primary hip arthroplasty.