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Acetabular Cup System

Product Information

REFLECTION Product Information

The REFLECTION Acetabular Cup System has led the industry in maximising fixation and minimising wear since 1992, offering a variety of choices, allowing the surgeon versatility for indication and preference. The MICROSTABLE liner locking mechanism and the patented polished inner surface reflect our continued leadership in advanced technology. The combination of our locking mechanism and polished surface virtually eliminates damage to the backside of the liner reducing the chance of backside wear.

Features and Benefits of REFLECTION by Smith & Nephew

  • MICROSTABLE liner locking mechanism
  • Highly Polished Inner Surface
  • RoughCoat Porous Coating
  • NO HOLE, SPIKED SHELL, and THREE HOLE options for primary
  • MULTI HOLE, PERIPHERAL HOLE for Revision surgeries
  • Taper lock screw hole covers, watertight apex hole cover
  • RoughCoat sintered bead porous coating allows for scratch fit and stresses the bone for bone in-growth.

Download the REFLECTION Surgical Techniques by clicking on the links below.

Clinical Evidence

Clinical Evidence

Comparative in vitro assessment of the primary stability of cementless press-fit acetabular cups

Acta Orthop. Belg., 2004, 70, 31-37.

Long-term stable osseointegration of porous-coated acetabular cups depends on bony ingrowth within their porous surface.

Download the REFLECTION Pull-out Strength Research 

Fixation of Ultrahigh-molecular-weight Polyethylene Liners to Metal-backed Acetabular Cups

The Journal of Arthroplasty Vol. 12 No. 1 1997.

Locking mechanisms and metal-liner interface surfaces of six modular acetabular systems were evaluated to determine their effect on micromotion and backside wear of the polyethylene liner.

Download the Fixation Article  


Midterm Results of 506 Solid Trispiked Reflection Cementless Acetabular Components for Primary Total Hip Arthroplasty

Journal of Arthroplasty 2010.11.014, Volume 00, No. 0 2011.

The purpose of this prospective study was to evaluate the outcomes and survivorship of a trispiked, sintered bead-coated titanium shell with a polished inner surface, no screw holes, and an improved locking mechanism.

Download Tri-Spiked Reflection Cementless Article  


Wear and Migration of Highly Cross-Linked and Conventional Cemented Polyethylene Cups with Cobalt Chrome or Oxinium Femoral Heads: A Randomized Radiostereometric Study of 150 Patients

This randomized study was performed to compare wear and migration of five different cemented total hip joint articulations in 150 patients.

Download XLPE Wear Article  



Highly cross-linked polyethylene acetabular liners retrieved four to five years after revision surgery: A report of two cases.

Journal of the Mechanical Behavior of Biomedical Materials, March 2010, pgs. 464-469.

The purpose of the present report is to quantify surface deviations in two XLPE liners implanted during revision THA and retrieved between four to five years after implantation.

Download Revision XLPE Comparison Article

Design and Technology

REFLECTION Design and Technology

MICROSTABLE liner locking mechanism
• Smooth scalloped design of locking mechanism minimizes damage to poly from locking into shell
• 24 positions allows you the interoperative flexibility to reposition
• The non-damaging lock mechanism allow repeated removal and reinsertion of the liner

Highly Polished Inner Surface
• Patented Polished inner surface reduces roughness to the standard required for femoral heads, further reducing backside wear

RoughCoat Porous Coating
• Sintered Ti Bead technology has been the gold standard in hip replacement for the last 10 years.
• 40% average porosity


REFLECTION Indications

Hip components are indicated for individuals undergoing primary and revision surgery where other treatments or devices have failed in rehabilitating hips damaged as a result of trauma or noninflammatory degenerative joint disease (NIDJD) or any of its composite diagnoses of:

• Osteoarthritis
• Avascular necrosis
• Traumatic arthritis
• Slipped capital epiphysis
• Fused hip
• Fracture of the pelvis and diastrophic variant.

Hip components are also indicated for inflammatory degenerative joint disease including:

• Rheumatoid arthritis
• Arthritis secondary to a variety of diseases and anomalies, and congenital dysplasia;
• Treatments of nonunion
• Femoral neck fracture
• Trochanteric fractures of the proximal femur with head involvement that are unmanageable using other techniques
• Endoprosthesis, femoral osteotomy
• Girdlestone resection
• Fracture-dislocation of the hip
• Correction of deformity.

Download the REFLECTION Surgical Techniques

REFLECTION All Poly XLPE Surgical Technique

REFLECTION Ceramic Surgical Technique

REFLECTION Constrained Liner Surgical Technique





Frequently Asked Questions

Is there acrylic in the ceramic-on-ceramic material?

Is ceramic-on-ceramic reamed one under or line-to-line?
1-2 under ream , refer to surgical technique

Can ceramic-on-ceramic be used with any stem?
No, is only FDA approved to be used with SPECTRON, SYNERGY, and ANTHOLOGY

Is our ceramic made from forte or delta?
REFLECTION ceramic is Biolox forte

What shells are used with the ceramic liners?
REFLECTION ceramic acetabular shells (with FSO 5 screw hole pattern)

Can the PLUS ceramic be used with our REFLECTION ceramic?
No, REFLECTION ceramic is a Class III device and only specific part numbers have been approved by the FDA for use in the system.

Can the constrained liner be placed in a 3-hole shell? If so, how is this done?
Yes. Refer to the constrained liner surgical technique

What are the thicknesses for the constrained liner?

Constrained liner 22mm head, size 46/48
Constrained liner 22mm head, size 50/52
Constrained liner 22mm head, size 54/56
Constrained liner 26mm head, size 50/52
Constrained liner 26mm head, size 54/56
Constrained liner 26mm head, size 58/60
Constrained liner 28mm head, size 54/56
Constrained liner 28mm head, size 58/60
Constrained liner 28mm head, size 62/64
Constrained liner 28mm head, size 66/68
Constrained liner 28mm head, size 70
Constrained liner 32mm head, size 62/64
Constrained liner 32mm head, size 66/68
Constrained liner 32mm head, size 70

What are the options for removing a ceramic head?
Once a ceramic head is removed, another ceramic head cannot be used.

What are the options for removing a ceramic head?

50-52mm 8 dome screw holes
54-60mm 10 dome screw holes
62-68mm 12 dome screw holes

INTERFIT Multi-hole:
50-52mm 8 dome screw holes
54-60mm 10 dome screw holes
62-68mm 12 dome screw holes
70-76mm 14 dome screw holes

Peripheral hole:
54-80mm 8 dome screw holes; 7 peripheral holes

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Smith & Nephew is providing information in this site for general educational use only, and does not intend for this to be construed as medical advice or used as a substitute for the advice of your physician. For questions or concerns about a previous or upcoming surgery, Smith & Nephew recommends that you contact your healthcare professional.