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Cementless acetabular reconstruction in revision total hip arthroplasty
Craig J Della Valle1, Richard A Berger, Aaron G Rosenberg
1Rush-Presbyterian-St. Luke's Medical Center, 1725 West Harrison, Suite 1063, Chicago, IL 60612, USA. craigdv@yahoo.com
Clinical Orthopaedics and Related Research
|April 2, 2004
Summary
Cementless acetabular revision using screws offers durable results for total hip arthroplasty (THA) revisions. This method shows an 81% component survivorship at 15 years, with a low failure rate due to loosening.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Arthroplasty Research
Background:
- Acetabular component revision in total hip arthroplasty (THA) presents significant challenges.
- Cementless acetabular components with screw fixation are a preferred method for acetabular revisions, demonstrating good intermediate-term outcomes.
Purpose of the Study:
- To evaluate the long-term efficacy and survivorship of cementless hemispheric acetabular components used in revision THA.
- To assess failure modes and radiographic evidence of loosening in these components over a 15-year period.
Main Methods:
- A retrospective review of 138 consecutive acetabular revisions using cementless, hemispheric acetabular components with Ti fiber metal mesh.
- Components were inserted with line-to-line reaming and screw fixation.
Main Results:
- At a mean of 15 years, 13.8% (19 components) required revision for various reasons including instability and infection.
- Component survivorship was 81% at 15 years (revision for any reason) and 96% for aseptic loosening.
- Only one component showed radiographic evidence of loosening.
Conclusions:
- Cementless acetabular revision with screw fixation provides durable, long-term results in THA.
- This reconstructive method demonstrates a low rate of failure specifically due to loosening, supporting its use in acetabular revisions.