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

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 (6185 mm3) providing optimal bone contact with the acetabular articular surface occurred with a 165° 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.