Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty.

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Reconstructive Surgery

Background:

• Acetabular revision surgery addresses aseptic failure of total hip arthroplasty.
• Extra-large uncemented components offer potential benefits in acetabular revision, particularly with bone loss.
• Limited data exists on the long-term efficacy of these larger implants.

Purpose of the Study:

• To evaluate the outcomes of extra-large uncemented porous-coated acetabular components used for revision surgery.
• To assess component survival and functional results in patients with acetabular bone loss.
• To determine the rate of aseptic loosening and other complications at a minimum five-year follow-up.

Main Methods:

• Eighty-nine extra-large uncemented acetabular components (Harris-Galante-I or II cups) were implanted in 89 patients (46 men, 43 women) undergoing revision for aseptic failure.
• Patients had a mean age of 59 years and significant acetabular bone deficiency (segmental or combined).
• Bone grafting (particulate or bulk) was utilized in a majority of cases; follow-up was at least five years.

Main Results:

• At a mean follow-up of 7.2 years, four components required re-revision or removal (two for aseptic loosening).
• The eight-year survival probability of the acetabular component was 93% (any reason for removal) and 98% (aseptic loosening).
• The mean modified Harris hip score improved significantly from 56 to 83 points; dislocation was the most frequent complication (11 patients).

Conclusions:

• Extra-large uncemented acetabular components are effective for revision surgery in the setting of bone loss.
• These implants demonstrate favorable intermediate-term results with a low incidence of aseptic loosening.
• The use of these components can lead to significant functional improvement in patients undergoing acetabular revision.