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[Acetabular reinforcement rings in revision total hip arthroplasty: midterm results in 298 cases]
U J Schlegel1, R G Bitsch, M Pritsch
1Klinik und Poliklinik für Orthopädie, Klinikum der Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50924 Köln, Deutschland. ulf.schlegel@gmx.net
Background:
Acetabular revision in total hip arthroplasty (THA), especially for loose or migrated cup components with collateral bone loss, remains a great surgical challenge. The aim should always be a functionally favorable reconstruction of the rotation center with sufficient load capacity of the acetabulum. Commonly used implants in Europe are the Mueller ring, the Ganz ring, and the Burch-Schneider cage.
Patients And Methods:
We report our results of 298 patients (298 hips) with a median follow-up period of 4 (range 0-17) years in a retrospective series.
Results:
Follow-up data were available in 224 cases (75%). A radiographic examination was performed in 176 (59%) patients. Another 54 patients (18%) had died in the follow-up period, while another three patients (1%) were lost to follow-up. Eighteen patients (16%) underwent re-revision, in nine cases for aseptic loosening and in the remaining nine cases for infection. In seven additional cases (2%), radiological and clinical failure was found during follow-up. The overall survival rate was 94% at 5 years and 89% at 8 years.
Conclusion:
Revision THA using acetabular reinforcement rings results in acceptable midterm results. However, septic complications and lysis of the bone graft with consecutive failure of the reinforcement ring remain problematic.