Reproducing the Proximal Femoral Anatomy: Large-Diameter Head THA

In the era of personalized medicine, we aim to reproduce the patient’s native anatomy and the physiological articular environment. Our new quest is to offer a forgotten hip joint to our patients. Currently, two factors may compromise this achievement: hip range of motion restrictions and hip instability. The supra-physiologic arc of motion provided by the large head–neck ratio of large diameter head (>36 mm) THA makes it a forgiving procedure, leaving some room for imprecision by the surgeon (especially in presence of spinopelvic variations). It also permits a better reproduction of individual patient anatomy (femoral offset and leg length). Bilateral and outpatient procedures are simplified. It allows unrestricted range of motion (ROM), for activities and work occupations. For these reasons, it may increase the likelihood of having a forgotten hip. LDH THA is currently available with ceramic bearing or metal on polyethylene dual mobility design.