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Outcomes of isolated acetabular revision
Bryan M Lawless1, William L Healy, Sanjeev Sharma
1Department of Orthopaedics, The Lahey Clinic, 41 Mall Road, Burlington, MA 01805, USA. bmlawles@hotmail.com
Clinical Orthopaedics and Related Research
|October 1, 2009
Summary
Isolated acetabular revision surgery improved patient pain and hip function. However, obesity was linked to reduced pain improvement, and 7% of patients required rerevision for aseptic loosening.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
Background:
- Isolated acetabular revision surgery presents challenges with variable patient outcomes and risk of hip instability.
- Assessing factors influencing outcomes is crucial for improving revision arthroplasty procedures.
Purpose of the Study:
- To evaluate the outcomes of isolated acetabular revision surgery.
- To investigate the impact of patient-specific factors (age, diagnosis, obesity) and surgical factors (bone stock, bone loss, augmentation) on pain and functional scores.
Main Methods:
- Retrospective analysis of 42 isolated acetabular revision operations.
- Radiographic assessment using Paprosky and Moore criteria, evaluating implant position, fixation, and osteolysis.
- Clinical follow-up for pain and Harris hip scores, recording complications and reoperations over a mean of 6.4 years.
Main Results:
- Significant improvement in mean pain scores and Harris hip scores postoperatively.
- No dislocations occurred; one infection and three acetabular rerevisions (7%) for aseptic loosening were recorded.
- Patient age, diagnosis, bone loss, and pelvic augmentation did not significantly influence outcomes. Obese patients showed less pain improvement compared to nonobese patients.
Conclusions:
- Isolated acetabular revision can lead to improved pain and function.
- Obesity may negatively impact pain improvement after revision surgery.
- Aseptic loosening remains a significant cause for rerevision, necessitating careful surgical technique and patient selection.