Revision of the acetabulum with a contemporary cementless component
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Published on: August 4, 2022
Robert W Wysocki1, Craig J Della Valle, Susan Shott
1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Insights
This study found that contemporary cementless acetabular components showed good performance in hip revision surgery but were inferior to earlier designs. Further research is needed to understand the multifactorial differences in revision hip arthroplasty outcomes.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Performance
Background:
- Acetabular revision surgery aims to restore hip joint function using prosthetic components.
- Cementless, porous-coated acetabular components are widely used in total hip arthroplasty.
- Long-term performance data for contemporary acetabular components in revision settings are crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the clinical and radiographic performance of a specific cementless acetabular component in revision hip arthroplasty.
- To compare the outcomes of this contemporary component with earlier generations of acetabular implants.
- To identify factors influencing the success or failure of acetabular revision surgery.
Main Methods:
- Prospective evaluation of 187 consecutive acetabular component revisions using a hemispherical porous-coated implant.
- Follow-up included standardized radiographs and Harris hip scores.
- Analysis of revision rates, aseptic loosening, and radiographic evidence of component loosening.
Main Results:
- 166 hips in 158 patients were available for follow-up at a mean of 91 months.
- A total of 11 acetabular components (7%) required re-revision, with 4 (2%) due to aseptic loosening.
- Radiographic follow-up revealed loosening in 7 of 145 unrevised components (5%).
Conclusions:
- Contemporary cementless acetabular components demonstrate acceptable outcomes in hip revision surgery.
- Performance was found to be inferior compared to earlier implant generations.
- The observed differences are likely attributable to a combination of factors, warranting further investigation.
Abstract:
We evaluated the performance of a contemporary cementless acetabular component at a minimum of 5 years postoperatively. One hundred eighty-seven consecutive acetabular component revisions were performed using a hemispherical porous-coated component. Patients were followed prospectively with radiographs and Harris hip scores. Twenty patients died, leaving 158 patients (166 hips) available for follow-up at a mean of 91 months. No patients were lost. Eleven acetabular components (7%) required repeated revision, including 4 (2%) for aseptic loosening. Seven of the 145 unrevised acetabular components with radiographic follow-up (5%) were loose. The results of acetabular revision with this contemporary acetabular component were good but inferior to those of earlier-generation implants. This difference is likely multifactorial.
