Independent contribution of elevated-rim acetabular liner and femoral head size to the stability of total hip implants

The use of an elevated-rim acetabular liner in total hip arthroplasty is widely accepted. We sought to determine quantitatively the amount of additional stability provided by the elevated-rim liner compared with the standard nonelevated liner. The stability of the hip with a 32-mm femoral head was compared with the standard 28-mm head. Our results show that a 15° elevated-rim acetabular liner placed in the posterior quadrant increased hip stability by an additional 8.9° of internal rotation. Similarly the 32-mm head provided 8.1° of additional internal rotation. The increases were statistically significant (P<.0001). We did not encounter increased anterior dislocation intraoperatively. The findings of this study indicate that the 32-mm head may contribute to hip stability in primary total hip arthroplasty, and in instances in which a posterior approach is used, an elevated-rim liner placed in the posterior quadrant may contribute independently to hip stability.