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Revision total hip arthroplasty for pelvic osteolysis with well-fixed cementless cup
Jun-Dong Chang1, Je-Hyun Yoo, Mina Hur
1Department of Orthopaedic Surgery, Hallym University College of Medicine, Seoul, Republic of Korea.
Insights
Revision total hip arthroplasty (THA) for pelvic osteolysis with well-fixed cementless cups yields favorable outcomes. This approach is particularly beneficial for younger patients requiring revision surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Radiology
Background:
- Pelvic osteolysis following total hip arthroplasty (THA) presents a complex challenge.
- Treatment options for pelvic osteolysis with well-fixed cementless cups are debated.
- Evaluating outcomes of revision THA in this specific patient cohort is crucial.
Purpose of the Study:
- To assess the clinical and radiographic outcomes of revision THA in patients with pelvic osteolysis.
- To determine the efficacy of using cementless cups in revision surgery for pelvic osteolysis.
- To identify patient subgroups that may benefit most from this revision strategy.
Main Methods:
- Retrospective evaluation of 62 hips undergoing revision THA for pelvic osteolysis.
- Inclusion criteria: well-fixed cementless acetabular cups.
- Data collected: patient demographics, surgical details (cementless vs. cemented cups, acetabular reinforcement rings), follow-up duration, Harris Hip Score, and radiographic assessment.
Main Results:
- Mean patient age was 50.9 years; mean interval from primary THA was 9.7 years.
- Revision involved cementless cups in 51 hips and cemented cups in 11.
- At a mean follow-up of 5.9 years, the average Harris Hip Score was 92.4 with minimal radiographic complications.
Conclusions:
- Revision total hip arthroplasty using cementless cups for pelvic osteolysis demonstrates favorable clinical and radiographic outcomes.
- This surgical approach is a viable option, especially for younger patients.
- The findings support the preferential use of cementless revision THA in select cases of pelvic osteolysis.
Abstract:
Treatment of pelvic osteolysis after total hip arthroplasty (THA) remains controversial. Clinical and radiographic outcomes of revision THA were evaluated in 62 hips with pelvic osteolysis and well-fixed cementless cups. The patients' mean age was 50.9 years, and the mean interval from primary to revision THA was 9.7 years. For revision, cementless cups were used in 51 hips, and cemented cups in 11 with acetabular reinforcement rings in 9. The mean duration of follow-up after revision THA was 5.9 years (range, 3.0-9.7 years). At final follow-up, the average Harris Hip Score was 92.4, and there was no radiographic complication except for 1 with change of inclination. Revision THA for pelvic osteolysis with well-fixed cementless cups showed favorable outcomes, and it can be preferentially used in young patients.