Acetabular revision in total hip replacement with a press-fit cup

The role of supplementary screw fixation in acetabular revisions remains uncertain. Prior research has shown mixed outcomes with and without screws. Some studies suggest screws may improve stability in complex cases. Others argue that press-fit cups alone can suffice in select patients. This uncertainty has driven further investigation into alternative fixation strategies. Surgeons seek reliable methods to avoid additional hardware. The long-term success of screwless techniques is not fully established. This gap motivated the current study to evaluate outcomes without screws.

This study aimed to assess the effectiveness of press-fit cups without screws in acetabular revisions. The focus was on hips with contained or small segmental defects. The researchers wanted to determine if screwless techniques could achieve stable results. They also sought to evaluate the risk of migration and osteolysis over time. Medium-term clinical and radiological outcomes were the primary goals. The study aimed to provide evidence for well-selected patient groups. It addressed the need for alternatives to traditional screw fixation. The motivation stemmed from the ongoing debate in orthopedic practice.

The study involved 439 acetabular revisions performed over an eight-year period. A subset of 171 hips with specific defect types was selected. The Morscher press-fit cup was implanted in these cases. No supplementary screws were used for additional fixation. Patients were followed prospectively for clinical and radiological outcomes. A total of 123 hips had a mean follow-up of 7.4 years. Radiological assessments were conducted at regular intervals. The study focused on migration patterns and signs of osteolysis.

Of the 123 hips reviewed, no press-fit cups required revision for aseptic loosening. Three hips showed radiological evidence of osteolysis. Cranial and medial migration up to 6 mm occurred in 44 hips (26%) at two years. No further migration was observed beyond the second post-operative year. The overall clinical outcomes were considered excellent. The results suggest stability without additional fixation. Migration stabilized after the initial two-year period. These findings support the use of press-fit cups in selected cases.

The authors suggest that acetabular revision without screws is feasible in well-selected patients. The study supports the use of press-fit cups in hips with contained defects. No revision for aseptic loosening was reported during the follow-up period. The migration observed was limited to the first two years. The results indicate that screwless techniques may be effective. The authors propose that press-fit cups can provide stable outcomes. They emphasize the importance of patient selection. These findings contribute to the ongoing debate in orthopedic surgery.