scholarly journals Acetabular Component Anteversion in Primary and Revision Total Hip Arthroplasty: An Observational Study

2013 ◽  
Vol 7 (1) ◽  
pp. 600-604
Author(s):  
Olav Reikerås ◽  
Ragnhild B. Gunderson
Keyword(s):  
Acetabular Component ◽  
Target Range ◽  
Ceramic Head ◽  
Revision Total Hip Arthroplasty ◽  
Acetabular Anteversion ◽  
Target Zone ◽  
Revision Tha ◽  
Free Hand Technique ◽  
Revision Operations ◽  
Acetabular Components

Purpose: In a prospective manner to evaluate the range of acetabular component anteversion actually achieved by the use of a cup positioner in cementless revision and primary THA. Methods: We operated 71 patients with cementless primary THA, and 26 patients with cementless acetabular revision surgery. We aimed to obtain cup anteversion of 10 to 30° with an impactor-positioner. In all cases we used elevated liners and a ceramic head with diameter 28. At 3 months postoperatively the component versions were measured using CT with the patient in supine position. Results: The acetabular component version in the primary hips ranged from 28° of retroversion to 42° of anteversion with a mean of 17.4 ± 14.0°, while the cup version in the revision hips ranged from 4° of retroversion to 32° of anteversion with a mean of 15.0 ± 9.6°(p=0.427). The anteversion of 40 (56%) of the primary acetabular components were within the target zone of 10 to 30°, while 19 (27%) were below the target zone and and 12 (17%) were above the target range. The anteversion of 19 (73%) of the revision acetabular components were within the target zone, while 6 (23%) were below the target zone and 1 (4%) were above the target range. The differences in distribution between the primary and revision operations were not significant (p=0.183). Conclusions: The intraoperative estimation of acetabular anteversion by free hand technique in many cases was not within the intended range of 10 to 30° in either primary or revision THA and with no differences between the two series

Preliminary results of a 3D-printed acetabular component in the management of extensive defects

2017 ◽  
Vol 28 (3) ◽  
pp. 266-271 ◽  
Author(s):  
Mustafa Citak ◽  
Lilly Kochsiek ◽  
Thorsten Gehrke ◽  
Carl Haasper ◽  
Eduardo M Suero ◽  
...  
Keyword(s):  
Bone Loss ◽  
Acetabular Component ◽  
Complication Rate ◽  
Primary Outcome Measure ◽  
Patient Specific ◽  
Component Technique ◽  
Revision Tha ◽  
3D Printed ◽  
Acetabular Defects ◽  
Acetabular Components

Introduction: The treatment of extensive bone loss and massive acetabular defects can be compounded by several challenges and pitfalls. The survivorship following acetabular revision with extensive bone loss is still unsatisfactory. The goal of the present study was to analyse the outcomes of 3D-printed patient-specific acetabular components in the management of extensive acetabular defects and combined pelvic discontinuity (PD). Methods: 9 patients underwent revision THA using 3D-printed custom acetabular components to reconstruct extensive acetabular defects. The Paprosky classifications were determined in all patients. The primary outcome measure was the implant-associated failure rate. Results: 1 out of 9 patients suffered an implant-associated complication (11%). The overall implant-associated survival rate was 89%. The overall complication rate was 56%. Conclusions: The patient-specific acetabular component technique shows promise for the treatment of patients with severe acetabular defects in revision THA. Further research aimed at reducing costs and improving the complication rate are warranted.

Is there a problem with modular dual mobility acetabular components in revision total hip arthroplasty at mid-term follow-up?

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 66-72
Author(s):  
Nicholas M. Hernandez ◽  
Zoe W. Hinton ◽  
Christine J. Wu ◽  
Paul F. Lachiewicz ◽  
Sean P. Ryan ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Revision ◽  
Revision Total Hip Arthroplasty ◽  
Dual Mobility ◽  
Revision Thas ◽  
Revision Tha ◽  
Acetabular Components ◽  
Acetabular Loosening

Aims Modular dual mobility (MDM) acetabular components are often used with the aim of reducing the risk of dislocation in revision total hip arthroplasty (THA). There is, however, little information in the literature about its use in this context. The aim of this study, therefore, was to evaluate the outcomes in a cohort of patients in whom MDM components were used at revision THA, with a mean follow-up of more than five years. Methods Using the database of a single academic centre, 126 revision THAs in 117 patients using a single design of an MDM acetabular component were retrospectively reviewed. A total of 94 revision THAs in 88 patients with a mean follow-up of 5.5 years were included in the study. Survivorship was analyzed with the endpoints of dislocation, reoperation for dislocation, acetabular revision for aseptic loosening, and acetabular revision for any reason. The secondary endpoints were surgical complications and the radiological outcome. Results The overall rate of dislocation was 11%, with a six-year survival of 91%. Reoperation for dislocation was performed in seven patients (7%), with a six-year survival of 94%. The dislocations were early (at a mean of 33 days) in six patients, and late (at a mean of 4.3 years) in four patients. There were three intraprosthetic dissociations. An outer head diameter of ≥ 48 mm was associated with a lower risk of dislocation (p = 0.013). Lumbrosacral fusion was associated with increased dislocation (p = 0.004). Four revision THAs (4%) were further revised for aseptic acetabular loosening, and severe bone loss (Paprosky III) at the time of the initial revision was significantly associated with further revision for aseptic acetabular loosening (p = 0.008). Fourteen acetabular components (15%) were re-revised for infection, and a pre-revision diagnosis of reimplantation after periprosthetic joint infection (PJI) was associated with subsequent PJI (p < 0.001). Two THAs had visible metallic changes on the backside of the cobalt chromium liner. Conclusion When using this MDM component in revision THA, at a mean follow-up of 5.5 years, there was a higher rate of dislocation (11%) than previously reported. The size of the outer bearing was related to the risk of dislocation. There was a low rate of aseptic acetabular loosening. Longer follow-up of this MDM component and evaluation of other designs are warranted. Cite this article: Bone Joint J 2021;103-B(7 Supple B):66–72.

Revision total hip arthroplasty using the Kerboull acetabular reinforcement device for Paprosky type III defects involving the inferior margin of the acetabulum

2018 ◽  
Vol 100-B (6) ◽  
pp. 725-732 ◽  
Author(s):  
E. Gibon ◽  
N. Barut ◽  
J-P. Courpied ◽  
M. Hamadouche
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Inferior Margin ◽  
Total Hip ◽  
Type Iii ◽  
Revision Tha ◽  
Reinforcement Device

Aims The purpose of this retrospective study was to evaluate the minimum five-year outcome of revision total hip arthroplasty (THA) using the Kerboull acetabular reinforcement device (KARD) in patients with Paprosky type III acetabular defects and destruction of the inferior margin of the acetabulum. Patients and Methods We identified 36 patients (37 hips) who underwent revision THA under these circumstances using the KARD, fresh frozen allograft femoral heads, and reconstruction of the inferior margin of the acetabulum. The Merle d’Aubigné system was used for clinical assessment. Serial anteroposterior pelvic radiographs were used to assess migration of the acetabular component. Results At a mean follow-up of 8.2 years (5 to 19.3), the mean Merle d’Aubigné score increased from 12.5 (5 to 18) preoperatively to 16.5 (10 to 18) (p < 0.0001). The survival rate at ten years was 95.3% (sd 4.5; 95% confidence interval (CI) 86.4 to 100) and 76.5% (sd 9.9, 95% CI 57.0 to 95.9) using aseptic loosening and radiological loosening as the endpoints, respectively. Conclusion These results show that the use of the KARD with reconstruction of the inferior margin of the acetabulum in revision THA is associated with acceptable clinical results and survival at mid-term follow-up with, however, a high rate of migration of the acetabular component of 21.6%. Cite this article: Bone Joint J 2018;100-B:725–32.

Comparative Survival Analysis of Porous Tantalum and Porous Titanium Acetabular Components in Total Hip Arthroplasty

2017 ◽  
Vol 27 (5) ◽  
pp. 505-508 ◽  
Author(s):  
Emil S. Vutescu ◽  
Peter Hsiue ◽  
Wayne Paprosky ◽  
Sumon Nandi
Keyword(s):  
Survival Analysis ◽  
Acetabular Component ◽  
Porous Metal ◽  
Porous Titanium ◽  
Acetabular Defect ◽  
Porous Tantalum ◽  
Revision Tha ◽  
Paprosky Classification ◽  
Acetabular Components

Background Porous tantalum acetabular components (PoTa) are well-studied, but less is known about widely used porous titanium (PoTi) acetabular components. We performed a comparative survival analysis between PoTi and PoTa acetabular components. Methods Primary or revision THA performed using PoTi (n = 2,976) or PoTa (n = 184) acetabular components with minimum 2-year follow-up (PoTi n = 1,539; PoTa n = 157) were analysed. Univariate and multivariate logistic regression were performed to test the effect of porous metal acetabular component type on revision surgery for aseptic cup loosening. Multivariate model was adjusted for acetabular defect severity according to the Paprosky Classification. Results Only PoTi components used in revision THA failed. Survival of the PoTi acetabular component was 98.6% when used in revision THA at mean 48.3-month follow-up. After adjusting for severity of acetabular defect, there was no difference in survival between PoTi and PoTa acetabular components when used in primary or revision THA. Conclusions After adjusting for acetabular defect severity, both PoTa and PoTi acetabular components had excellent survival at mean 44.4-month (range 4.3-91.5 months) follow-up when used in primary and revision THA.

Radiolucent lines do not affect the longevity of highly cross-linked polyethylene cemented components in total hip arthroplasty

2021 ◽  
Vol 103-B (10) ◽  
pp. 1604-1610
Author(s):  
Yusuke Takaoka ◽  
Koji Goto ◽  
Jiro Tamura ◽  
Yaichiro Okuzu ◽  
Toshiyuki Kawai ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Long Term Outcome ◽  
Total Hip ◽  
Radiolucent Lines ◽  
Kaplan Meier ◽  
Acetabular Components

Aims We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. Methods We retrospectively reviewed 170 patients who underwent 187 total hip arthroplasties at two hospitals with a minimum follow-up of ten years. All interventions were performed using the same combination of HXLPE cemented acetabular components with femoral stems made of titanium alloy. Kaplan-Meier survival analysis was performed for the primary endpoint of acetabular component revision surgery for any reason and secondary endpoint of the appearance of RLLs. RLLs that had appeared once were observed over time. We statistically assessed potential relationships between RLLs and a number of factors, including the technique of femoral head autografting and the Japanese Orthopaedic Association score. Results The mean follow-up period was 13.0 years (10.0 to 16.3). Femoral head autografting was performed on 135 hips (72.2%). One acetabular component was retrieved because of deep infection. No revision was performed for the aseptic acetabular loosening. The Kaplan-Meier survival curve for the primary and secondary endpoints were 98.2% (95% confidence interval (CI) 88.6% to 99.8%) and 79.3% (95% CI 72.8% to 84.6%), respectively. RLLs were detected in 38 hips (21.2%), at a mean of 1.7 years (1 month to 6 years) postoperatively. None of the RLLs were progressive, and the presence of RLLs did not show a significant association with the survival and clinical score. RLLs were more frequently observed in hips without femoral head autografts than in those with autografts. Conclusion The use of HXLPE cemented acetabular components in total hip arthroplasty demonstrated excellent clinical outcomes after ten years, and no RLLs were progressive, and their presence did not affect the outcome. Femoral head autografting did not negatively impact the acetabular component survival or the appearance of RLLs. Cite this article: Bone Joint J 2021;103-B(10):1604–1610.

Improving Initial Acetabular Component Stability in Revision Total Hip Arthroplasty

2012 ◽  
Vol 27 (2) ◽  
pp. 305-309 ◽  
Author(s):  
David J. Jacofsky ◽  
John D. McCamley ◽  
Andrew M. Jaczynski ◽  
M. Wade Shrader ◽  
Marc C. Jacofsky
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip

The effect of cemented acetabular component geometry on the risk of revision for instability or loosening

2021 ◽  
Vol 103-B (11) ◽  
pp. 1669-1677
Author(s):  
Hiren M. Divecha ◽  
Terence W. O'Neill ◽  
Mark Lunt ◽  
Tim N. Board
Keyword(s):  
Acetabular Component ◽  
Posterior Wall ◽  
Revision Thas ◽  
Joint Registry ◽  
Binomial Regression ◽  
Prosthetic Head ◽  
Group A ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Acetabular Components

Aims To determine if primary cemented acetabular component geometry (long posterior wall (LPW), hooded, or offset reorientating) influences the risk of revision total hip arthroplasty (THA) for instability or loosening. Methods The National Joint Registry (NJR) dataset was analyzed for primary THAs performed between 2003 and 2017. A cohort of 224,874 cemented acetabular components were included. The effect of acetabular component geometry on the risk of revision for instability or for loosening was investigated using log-binomial regression adjusting for age, sex, American Society of Anesthesiologists grade, indication, side, institution type, operating surgeon grade, surgical approach, polyethylene crosslinking, and prosthetic head size. A competing risk survival analysis was performed with the competing risks being revision for other indications or death. Results The distribution of acetabular component geometries was: LPW 81.2%; hooded 18.7%; and offset reorientating 0.1%. There were 3,313 (1.5%) revision THAs performed, of which 815 (0.4%) were for instability and 838 (0.4%) were for loosening. Compared to the LPW group, the adjusted subhazard ratio of revision for instability in the hooded group was 2.31 (p < 0.001) and 4.12 (p = 0.047) in the offset reorientating group. Likewise, the subhazard ratio of revision for loosening was 2.65 (p < 0.001) in the hooded group and 13.61 (p < 0.001) in the offset reorientating group. A time-varying subhazard ratio of revision for instability (hooded vs LPW) was found, being greatest within the first three months. Conclusion This registry-based study confirms a significantly higher risk of revision after cemented THA for instability and for loosening when a hooded or offset reorientating acetabular component is used, compared to a LPW component. Further research is required to clarify if certain patients benefit from the use of hooded or offset reorientating components, but we recommend caution when using such components in routine clinical practice. Cite this article: Bone Joint J 2021;103-B(11):1669–1677.

Sign in / Sign up

Export Citation Format

Share Document