note whether the acetabular component is same size or 1-2 mm > reamers;
it is essential to obtain a tight metal to bone fit at the time of surgery, inorder to avoid subsequent loosening;
the surgeon should not expect that residual metal - bone gaps will fill in w/ bone;
it has also been demonstrated by Kim YS, et al (1995) that underreaming by more than 2 mm leaves gaps in the prosthesis-bone interval in the polar portion of the acetabulum;
because of this some surgeons have gone back to line to line reaming with hemispherical components;
this reduces the likelihood of fracture and maximizes bony contact;
oversized components with peripheral dome contact risk frx in osteoporotic bone and cannot be expected to achieve full metal to bone contact over the more central portions of the component;
in contrast, Della Valle CJ, et al (2004), the authors reported initial good results with line to line reaming w/ screw fixation but noted better stability and subsequent results with underreaming by 2 mm;
these results are supported by the bench top study by Curtis, et al (1992) in which the authors advocate underreaming by 2-3 mm;
