Trabecular Metal in Acetabular Revision Surgery for Severe Bone Defects and Pelvic Discontinuity

2018 ◽  
pp. 173-197
Author(s):  
José Sueiro-Fernandez
Keyword(s):  
Revision Surgery ◽  
Bone Defects ◽  
Acetabular Revision ◽  
Trabecular Metal ◽  
Pelvic Discontinuity

Measuring bone defects for acetabular revision surgery for choosing an appropriate reconstruction strategy: A concept study on plastic models

2019 ◽  
Vol 111 ◽  
pp. 103336
Author(s):  
Lukas Dankl ◽  
Agnes Mayr ◽  
Gerhard Kaufmann ◽  
Martin Thaler ◽  
Michael Nogler ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Bone Defects ◽  
Acetabular Revision ◽  
Concept Study ◽  
Reconstruction Strategy

Double-trabecular metal cup technique for the management of Paprosky type III defects without pelvic discontinuity

2018 ◽  
Vol 28 (2_suppl) ◽  
pp. 66-72 ◽  
Author(s):  
Mattia Loppini ◽  
Paolo Schiavi ◽  
Antonello Della Rocca ◽  
Francesco Traverso ◽  
Federico Della Rocca ◽  
...  
Keyword(s):  
Bone Defects ◽  
Acetabular Reconstruction ◽  
Trabecular Metal ◽  
Acetabular Bone ◽  
Pelvic Discontinuity ◽  
Type Iii ◽  
Heterotopic Ossifications ◽  
Radiographic Outcomes ◽  
Acetabular Bone Defects

Introduction: Modular reconstruction systems based on trabecular metal (TM) prosthetic components have been increasingly used in the last decade for the management of severe acetabular bone defects. The aim of this study was to assess the clinical and radiographic outcomes of double-cup technique for the management of Paprosky type III defects without pelvic discontinuity. Methods: A retrospective review was performed for all patients undergoing acetabular reconstruction with 2 TM cups at a tertiary referral centre between 2010 and 2015. Harris Hip Scores (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated preoperatively and at the latest follow-up. Radiographic assessment of the hip centre of rotation (COR) position and leg length discrepancy (LLD) was performed preoperatively and postoperatively. Osteolysis and radiolucencies, loosening of the implants, and heterotopic ossifications were evaluated with the latest follow-up radiographs. Results: Patients included 5 men and 11 women (16 hips) with an average age of 68 (45–81) years. Acetabular bone defects included 9 Paprosky type IIIB and 7 type IIIA defects. No pelvic discontinuities were registered. The mean follow-up was 34 (24–72) months. HHS and WOMAC scores, LLD and COR position significantly improved after surgery. In only 1 (6.3%) hip a not progressive radiolucent line adjacent the acetabular construct was noted. Heterotopic ossifications were found in 2 (12.5%) hips. No patients underwent acetabular components revision surgery for any reason. Conclusion: The double-cup technique could be considered an effective management of selected Paprosky type III defects without pelvic discontinuity providing excellent clinical and radiographic outcomes in the short term.

Do trabecular metal cups achieve better results when compared to hemispherical porous titanium cups in acetabular revision surgery?

2020 ◽  
pp. 112070002091994
Author(s):  
Ana Cruz-Pardos ◽  
Eduardo García-Rey ◽  
Ricardo Fernandez-Fernández ◽  
José Ortega-Chamarro
Keyword(s):  
Bone Loss ◽  
Aseptic Loosening ◽  
Revision Surgery ◽  
Porous Titanium ◽  
Acetabular Revision ◽  
Trabecular Metal ◽  
Acetabular Bone ◽  
Kaplan Meier ◽  
Acetabular Bone Loss ◽  
Significant Difference

Background: Trabecular metal (TM) cups were introduced in order to achieve better ingrowth and stability of the cup in acetabular revision surgery. As their use has evolved over time, we have queried whether TM cups would improve results in terms of the rate of aseptic loosening when compared to historical uncemented porous titanium cups used in revision surgery for acetabular bone loss in Hospital La Paz (Madrid, Spain). Methods: We retrospectively reviewed 197 acetabular revisions performed between 1991 and 2015. Titanium cups were used in 81 cases and TM cups in 116. The mean follow-up was 8.1 years (range 1–15); 12.0 ± 7.8 for titanium group and 5.4 ± 3.1 for TM group. The most common reason for revision was aseptic loosening. A Kaplan-Meier analysis was used to determine the survival of the cup, with radiological failure and re-revision due to aseptic loosening as the endpoints. Cox multivariate regression analyses were performed to assess different risk factors for failure. Results: 1 TM cup and 1 titanium cup were re-revised due to aseptic loosening ( p = 0.61). Radiological cup loosening was observed in 4 TM cups and 2 titanium cups ( p = 1.0). At 6 years, the probability of not having radiological cup loosening was 97.4% (95% CI, 93.9–100) for the titanium cups and 95.1% for the TM cups (95% CI, 90.1–99.9) ( p = 0.59). Another 5 cups were re-revised due to dislocation. Hips with a greater Paprosky defect showed a higher risk of loosening ( p < 0.05, hazard risk (HR) 3.04; 95% CI, 0.97–9.54). Conclusions: This study shows there was no significant difference in re-revision due to aseptic loosening or radiological loosening between titanium and TM cups in revision surgery for acetabular bone loss. Both types of cups demonstrate excellent results with a low failure rate and minimal complications.

Pelvic discontinuity in acetabular revision surgery

1998 ◽  
Vol 13 (2) ◽  
pp. 225-226
Author(s):  
Daniel J. Berry ◽  
Arlen D. Hanssen ◽  
David G. Lewallen ◽  
Miguel E. Cabanela
Keyword(s):  
Revision Surgery ◽  
Acetabular Revision ◽  
Pelvic Discontinuity
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