Effect of femoral component head size on movement of the two-component hemi-arthroplasty

The movement of 75 two-component hemi-arthroplasties, implanted following displaced subcapital fracture of the femoral neck, were examined radiologically in equal numbers of Hastings hips (22mm), 22-mm Bi-articular hips and 32-mm Bi-articular hips. A classification of the movement of the two-component hemi-arthroplasty was devised. The 22-mm Bi-articular hips showed predominantly intraprosthetic movement compared with the 32-mm Bi-articular hips, where movement was mainly extraprosthetic, thus confirming in vivo the Charnley low friction principle. True bipolar movement was found predominantly in the Hastings hips. In selecting a two-component hemi-arthroplasty, the prosthesis of choice is therefore one with a 22-mm rather than a 32-mm femoral head.