{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:50Z","timestamp":1788847670828,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Restoring the center of rotation (COR) in total hip arthroplasty (THA) is essential. We hypothesized that relatively smaller cups are associated with COR displacement. Our aim is to evaluate how acetabular cup size (ACS), relative to the radiographically measured femoral head diameter (FHD), correlates with COR positioning in THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 251 patients undergoing unilateral THA using a posterolateral approach with a non-arthritic contralateral hip that was used to assess FHD on preoperative x-ray. From postoperative radiographs, cranial cup displacement (cCD) and medial cup displacement (mCD) relative to contralateral hip COR were measured. Patients were divided into three groups based on the difference between ACS and FHD (\n                      <jats:italic>\u0394<\/jats:italic>\n                      ): Group A (\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u22642.5\u2005mm), Group B (2.5\u2005mm&amp;lt;\n                      <jats:italic>\u0394<\/jats:italic>\n                      &amp;lt;8.5\u2005mm), and Group C (\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u22658.5\u2005mm). Patients with a cCD &amp;lt;3\u2005mm and mCD &amp;lt;5\u2005mm were included in the \u201cRestored COR\u201d group; the others in the \u201cNon-Restored COR\u201d group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean cCD and mCD values were: 3.93\u2009\u00b1\u20094.29\u2005mm and 5.13\u2009\u00b1\u20094.13\u2005mm (Group A), 2.14\u2009\u00b1\u20093.25\u2005mm and 2.56\u2009\u00b1\u20093.28\u2005mm (Group B), 2.41\u2009\u00b1\u20092.75\u2005mm and 2.06\u2009\u00b1\u20093.09\u2005mm (Group C); Group A showed significantly higher cCD and mCD than Groups B and C (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In Group A, the relative risk (RR) of non-restored COR was 1.55 (95% CI 1.26\u20131.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) compared to group B\u2009+\u2009C. Patients with Restored COR (46.6%) had lower FHD than patients with Non-Restored COR (53.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>COR restoration in THA is influenced by cup size. The implant of cups with ACS \u2264 FHD+2.5\u2005mm is associated with a significantly increased risk of COR displacement, especially in patients with larger FHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III (retrospective comparative cohort study).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1931094","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:35:42Z","timestamp":1788845742000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Center of rotation restoration and acetabular cup sizing in total hip arthroplasty: the predictive role of radiographic femoral head diameter. A single-center study from the FP-UCBM hip study group"],"prefix":"10.3389","volume":"13","author":[{"given":"Biagio","family":"Zampogna","sequence":"first","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]},{"name":"BIOMORF Department of Biomedical, Dental, Morphological and Functional Images, University of Messina, Department of Orthopaedic and Trauma Surgery, A.O.U. Policlinico \u201cG. Martino\u201d","place":["Messina, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Del Monaco","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Rosario","family":"Parisi","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Paciotti","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Zampoli","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Ferrini","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Zagaria","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antongiulio","family":"Manfreda","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferruccio","family":"Vorini","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Papalia","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"179","DOI":"10.5371\/hp.2019.31.4.179","article-title":"Total hip arthroplasty: past, present, and future. 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