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Revision Total Hip Arthroplasty with Retained Acetabular Component.
Muyibat A Adelani1, Nathan A Mall2, Humaa Nyazee1
1Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for M.A. Adelani: muyibat.adelani@gmail.com.
Revision total hip arthroplasty retaining the acetabular component shows good outcomes when positioned correctly. Improper inclination or conventional polyethylene increases failure risk, highlighting the importance of component positioning and material choice for prosthetic survival.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Arthroplasty Research
Background:
- Aseptic loosening and osteolysis are primary causes of total hip prosthesis failure.
- Retaining a well-fixed acetabular component in revision surgery offers advantages over complete acetabular revision.
- Clinical success and long-term prosthetic survival after acetabular component retention require further investigation.
Purpose of the Study:
- To evaluate the mid-term to long-term prosthetic survival after revision total hip arthroplasty with acetabular component retention.
- To determine the impact of acetabular component position, polyethylene type, and surgical techniques on outcomes.
- To assess factors influencing prosthetic survival in revision hip arthroplasty.
Main Methods:
- Retrospective review of 100 hips in 100 patients undergoing revision total hip arthroplasty with acetabular component retention.
- Analysis of prerevision radiographs to measure acetabular component inclination and anteversion relative to safe zones.
- Review of operative reports for details on polyethylene type, liner insertion, femoral component revision, and bone grafting.
Main Results:
- Significant improvements in Harris hip score and UCLA activity score were observed postoperatively (p < 0.0001 and p < 0.01).
- Overall failure rate was 13%, with 6% experiencing postoperative instability.
- Acetabular components outside the safe zone for inclination (p = 0.048) and use of conventional polyethylene (p = 0.025) were associated with increased failure rates.
Conclusions:
- Revision total hip arthroplasty with acetabular component retention yields good outcomes when the component is appropriately positioned and well-fixed.
- Acetabular component inclination outside the safe zone and the use of conventional polyethylene are risk factors for failure.
- Optimal component positioning and modern polyethylene materials are crucial for successful revision hip arthroplasty outcomes.
