Extra-large press-fit cups without screws for acetabular revision.

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Reconstructive Surgery

Background:

• Acetabular revision surgery aims to restore hip joint function and stability.
• Press-fit cups are commonly used, but stability in complex cases remains a challenge.
• The role of extra-large hemispherical cups without screw fixation requires further investigation.

Purpose of the Study:

• To evaluate the clinical and radiologic outcomes of acetabular revisions using extra-large hemispherical press-fit cups.
• To assess the long-term stability and functional improvement provided by these implants.
• To determine the necessity of additional screw fixation for these specific implants.

Main Methods:

• Retrospective clinical and radiologic follow-up of 60 acetabular revision cases.
• Utilized extra-large hemispherical press-fit cups, with bone grafts in 17 instances.
• Assessed implant fixation, migration, and patient-reported functional scores (Harris Hip Score).

Main Results:

• 95% of cups demonstrated firm radiological fixation at 4-6 year follow-up.
• Significant improvement in Harris Hip Score from 58.7 preoperatively to 90.6 postoperatively.
• One cup loosened requiring re-revision; initial migration in 6 cases showed no progression.

Conclusions:

• Extra-large hemispherical press-fit cups offer sufficient stability in acetabular revision, even in severe cases.
• These cups often achieve stable fixation without the need for additional screw fixation, provided adequate friction.
• The study supports the use of these implants for successful acetabular reconstruction with good functional outcomes.