Acetabular Revision Using a Trabecular Metal Acetabular Component for Severe Acetabular Bone Loss Associated With a Pelvic Discontinuity

2006 ◽  
Vol 21 (2) ◽  
pp. 310 ◽  
Author(s):  
Scott M. Sporer ◽  
Wayne G. Paprosky
Keyword(s):  
Bone Loss ◽  
Acetabular Component ◽  
Acetabular Revision ◽  
Trabecular Metal ◽  
Acetabular Bone ◽  
Pelvic Discontinuity ◽  
Acetabular Bone Loss

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.

Short-term Results of a Custom Triflange Acetabular Component for Massive Acetabular Bone Loss in Revision THA

Orthopedics ◽  
2013 ◽  
Vol 36 (3) ◽  
pp. e260-e265 ◽  
Author(s):  
Michael A. Wind ◽  
Michael L. Swank ◽  
Joel I. Sorger
Keyword(s):  
Bone Loss ◽  
Acetabular Component ◽  
Short Term ◽  
Acetabular Bone ◽  
Acetabular Bone Loss ◽  
Revision Tha

scholarly journals Use of porous trabecular metal augments with impaction bone grafting in management of acetabular bone loss

2012 ◽  
Vol 83 (4) ◽  
pp. 347-352 ◽  
Author(s):  
W Steven Borland ◽  
Raj Bhattacharya ◽  
James P Holland ◽  
Nigel T Brewster
Keyword(s):  
Bone Loss ◽  
Bone Grafting ◽  
Trabecular Metal ◽  
Impaction Bone Grafting ◽  
Acetabular Bone ◽  
Acetabular Bone Loss

Cup-cage reconstruction for severe acetabular bone loss and pelvic discontinuity

2018 ◽  
Vol 100-B (11) ◽  
pp. 1442-1448 ◽  
Author(s):  
C. Hipfl ◽  
V. Janz ◽  
J. Löchel ◽  
C. Perka ◽  
G. I. Wassilew
Keyword(s):  
Bone Loss ◽  
Revision Surgery ◽  
Hip Dislocation ◽  
Harris Hip Score ◽  
Postoperative Function ◽  
Acetabular Bone ◽  
Pelvic Discontinuity ◽  
Acetabular Bone Loss ◽  
The Mean

AimsSevere acetabular bone loss and pelvic discontinuity (PD) present particular challenges in revision total hip arthroplasty. To deal with such complex situations, cup-cage reconstruction has emerged as an option for treating this situation. We aimed to examine our success in using this technique for these anatomical problems.Patients and MethodsWe undertook a retrospective, single-centre series of 35 hips in 34 patients (seven male, 27 female) treated with a cup-cage construct using a trabecular metal shell in conjunction with a titanium cage, for severe acetabular bone loss between 2011 and 2015. The mean age at the time of surgery was 70 years (42 to 85) and all patients had an acetabular defect graded as Paprosky Type 2C through to 3B, with 24 hips (69%) having PD. The mean follow-up was 47 months (25 to 84).ResultsThe cumulative five-year survivorship of the implant with revision for any cause was 89% (95% confidence interval (CI) 72 to 96) with eight hips at risk. No revision was required for aseptic loosening; however, one patient with one hip (3%) required removal of the ischial flange of the cage due to sciatic nerve irritation. Two patients (6%; two hips) suffered from hip dislocation, whereas one patient (one hip) required revision surgery with cement fixation of a dual-mobility acetababular component into a well-fixed cup-cage construct. Two patients (6%; two hips) developed periprosthetic infection. One patient was successfully controlled with a two-stage revision surgery, while the other patient underwent excision arthroplasty due to severe medical comorbidities. For the whole series, the Harris Hip Score significantly improved from a mean of 30 (15 to 51) preoperatively to 71 (40 to 89) at the latest follow-up (p < 0.001).ConclusionOur findings suggest that cup-cage reconstruction is a viable option for major segmental bone defects involving the posterior column and PD. It allows adequate restoration of the acetabulum centre with generally good stability and satisfactory postoperative function. Instability and infection remain drawbacks in these challenging revision cases. Cite this article: Bone Joint J 2018;100-B:1442–48.

scholarly journals Acetabular revision using ReadiGraft® BLX Putty and cortical/cancellous bone chips

2021 ◽  
Vol 2 (2) ◽  
pp. 037-045
Author(s):  
Giampietro Bertasi ◽  
Mariana Peroni
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Successful Outcome ◽  
Defect Classification ◽  
Acetabular Defect ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Bone ◽  
Pelvic Discontinuity ◽  
Acetabular Bone Loss ◽  
Operative Assessment

Acetabular bone loss presents a challenge to the revision total hip arthroplasty surgeon. It is described a technique of stressing the acetabular bone intra-operatively to access for pelvic discontinuity and the use of allograft to fill the bone gap. Three radiographic criteria are assessed on the AP radiograph for pre-operative classification according to the Paprosky system. This paper describes the pre-operative assessment, the acetabular defect classification and the surgery to achieve a successful outcome.

Sign in / Sign up

Export Citation Format

Share Document