Acetabular revisions using trabecular metal cups and augments.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Acetabular revision surgery is challenging, particularly with significant pelvic bone loss.
• Traditional implants may have limitations in achieving stable fixation in these complex cases.

Purpose of the Study:

• To evaluate the efficacy of trabecular metal (TM) shells and augments in acetabular revisions with significant pelvic bone loss.
• To assess clinical and radiographic outcomes of TM components in revision total hip arthroplasty.

Main Methods:

• Retrospective review of 97 cases undergoing acetabular revision for loose total hip arthroplasty.
• Inclusion criteria: Paprosky grade IIA or higher pelvic bone loss.
• Treatment involved TM revision acetabular components with or without modular augments.

Main Results:

• Average Harris hip score improved from 55 to 76 postoperatively.
• 88% of cups showed no lucent lines, indicating stable fixation.
• Low revision rates for infection (8%) and instability (1%); no aseptic failures.

Conclusions:

• Trabecular metal acetabular cups and shells are effective for revising failed components in patients with substantial pelvic bone loss.
• TM components provide durable fixation and functional improvement in complex acetabular reconstructions.
• The use of modular augments further enhances reconstructive capabilities in challenging cases.