Current Concepts of Using Large Femoral Heads in Total Hip Arthroplasty

Instability and dislocation after total hip arthroplasty are the most common causes of revisions and major complications for failure of inserted prostheses, leading to a reduction in quality of life. Because the use of artificial femoral head sizes smaller than patient's own size is the important cause for dislocation, the use of large femoral head have increased. Femoral head sizes greater than 32 mm offer multiple advantages in physical function and activity levels of patients by improving hip stability, decreasing dislocation rate and increasing range of motion. However, various concerns are encountered including wear debris generation at the trunnion-bore interface and increases in frictional torque and stress over the component-bone interface when using larger head sizes. So, the use of femoral head sizes less than 40 mm is recommended.