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Acetabular Reconstruction in Total Hip Arthroplasty.

Won Yong Shon1, Siva Swaminathan Santhanam1, Jung Woo Choi1

  • 1Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Hip & Pelvis
|August 19, 2016
PubMed
Summary

Acetabular reconstruction in revision hip surgery addresses bone defects using various components. Highly porous metals and modular augments show promise for complex cases, improving outcomes in revision total hip arthroplasty.

Keywords:
Acetabular reconstructionAllograftRevisionTotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science

Background:

  • Bone-deficient acetabulum presents significant challenges in hip revision surgery.
  • Traditional reconstruction methods like allografts with cages have high complication rates.
  • Evolving techniques aim to improve bone stock restoration and long-term implant survival.

Purpose of the Study:

  • To review and summarize current options for acetabular reconstruction in revision total hip arthroplasty.
  • To discuss the author's experience with various acetabular revision strategies.
  • To highlight advancements in materials and techniques for complex acetabular defects.

Main Methods:

  • Review of surgical techniques for acetabular reconstruction based on bone defect classification.
  • Discussion of component selection criteria, including hemispherical cups, cages, allografts, modular augments, and highly porous metals.
  • Synthesis of clinical outcomes and complication rates associated with different reconstructive approaches.

Main Results:

  • Hemispherical components with porous surfaces are suitable for minor defects.
  • Complex defects may require structural allografts with cages, but report high complications.
  • Modular augments and highly porous metal implants, such as trabecular metal cups, demonstrate satisfactory outcomes and optimize biological fixation.

Conclusions:

  • Acetabular reconstruction in revision hip arthroplasty requires tailored approaches based on bone loss.
  • Highly porous metals and modular augments represent promising advancements for managing major acetabular defects.
  • These newer options may offer improved biological fixation and better long-term results compared to older methods.