Cement-in-cement acetabular revision with a constrained tripolar component.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Arthroplasty Research

Background:

• Dislocation is a common complication after total hip arthroplasty (THA), often necessitating revision surgery.
• Cement-in-cement acetabular revision is an alternative to complete cement mantle removal, which carries significant risks.
• Existing literature primarily focuses on cement-in-cement femoral stem revision.

Observation:

• A case report details a 74-year-old woman with recurrent dislocations undergoing cement-in-cement acetabular revision using a constrained tripolar component.
• The procedure involved reaming, surface roughening, and meticulous cleaning of the existing cement mantle before cementing the new component.
• Postoperative outcomes were favorable, with significant improvement in the Oxford Hip Score.

Findings:

• Cement-in-cement acetabular revision with a constrained component successfully addressed recurrent dislocations in this case.
• The technique preserved the primary cement mantle, avoiding the complications associated with its complete removal.
• Good short-term clinical and radiological results were achieved, indicating the efficacy of this approach.

Implications:

• This case supports the cement-in-cement technique for acetabular revision in select THA patients with recurrent instability.
• Proper preparation of the primary cement surface (irrigation, drying, roughening) is crucial for successful cement bonding.
• Further clinical and biomechanical studies are warranted to establish the long-term efficacy and indications for this revision strategy.