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Revision total hip arthroplasty using a cementless acetabular component: technique and results
C D Silverton1, A G Rosenberg, M B Sheinkop
1Department of Orthopaedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Seminars in Arthroplasty
|March 9, 1995
Summary
Cementless acetabular revision surgery using titanium mesh components showed excellent long-term stability. This approach for aseptic loosening demonstrated a low revision rate, suggesting superiority over cemented methods.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Reconstructive Surgery
Background:
- Aseptic loosening is a primary cause of failure in acetabular revision surgery.
- Cementless implants offer potential advantages in long-term fixation for hip revisions.
- Titanium mesh coatings provide a porous surface for bone ingrowth.
Purpose of the Study:
- To evaluate the long-term outcomes of cementless hemispherical acetabular revision.
- To assess implant stability, revision rates, and radiographic findings.
- To compare the efficacy of titanium mesh components with historical cemented revisions.
Main Methods:
- 138 acetabular revisions were performed using cementless hemispherical components with titanium mesh coating and screw fixation.
- Follow-up included clinical assessment and radiographic review.
- Survival analysis and radiographic evaluation for stability and radiolucency were conducted.
Main Results:
- At a mean follow-up of 100 months, 91% of the cups were radiographically stable.
- The overall revision rate was 11%, with no revisions for aseptic loosening.
- Radiolucency was observed in a minority of cases, with minimal evidence of osteolysis.
Conclusions:
- Cementless acetabular revision with titanium mesh components demonstrates favorable long-term results.
- This technique shows a low failure rate due to aseptic loosening.
- The outcomes appear superior to those reported for cemented acetabular revisions.