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Impingement with Total Hip Replacement

¹ The Arthritis Institute, 501 East Hardy Street, 3rd Floor, Inglewood, CA 90301. E-mail address for L.D. Dorr: Patriciajpaul{at}yahoo.com

Investigation performed at The Arthritis Institute, Inglewood, California

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Zimmer. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (ORTHOsoft). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Impingement is influenced by prosthetic design, component position, biomechanical factors, and patient variables.

Evidence linking impingement to dislocation and accelerated wear comes from implant retrieval studies.

Operative principles that maximize an impingement-free range of motion include correct combined acetabular and femoral anteversion and an optimal head-neck ratio.

Operative techniques for preventing impingement include medialization of the cup to avoid component impingement and restoration of hip offset and length to avoid osseous impingement.

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