Use of dual mobility cup cemented into a tantalum acetabular shell for hip revision with large bone loss can decrease...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Porous tantalum components offer fixation stability in hip revision but do not inherently reduce dislocation rates.
• Dual mobility (DM) cups are increasingly used to address recurrent instability after hip arthroplasty.
• The combined efficacy of tantalum reconstruction devices and DM cups for instability in revision hip arthroplasty requires further investigation.

Purpose of the Study:

• To evaluate the dislocation rate and other complications at a minimum 5-year follow-up for acetabular reconstructions using porous tantalum components and cemented DM cups.
• To assess radiographic outcomes, including osseointegration and restoration of the hip center.
• To determine the clinical results and functional outcomes in patients undergoing complex acetabular reconstruction.

Main Methods:

• A retrospective study included 35 hips (35 patients) undergoing revision total hip arthroplasty (THA) with acetabular reconstruction using trabecular metal (TM) acetabular cups and cemented DM cups.
• Patients with Paprosky acetabular defect types 2C, 3A, and 3B were included.
• Follow-up involved clinical and radiological evaluations assessing dislocation, infection, reoperation, osseointegration, hip center restoration, Harris hip score, and psoas impingement.

Main Results:

• At a mean follow-up of 8.1 years, only one dislocation and one acute deep infection were recorded.
• No cup re-revisions for aseptic or septic loosening occurred, with 8-year survivorship at 96.5%.
• Radiographic analysis showed no acetabular migration, successful restoration of hip centers in 97.1% of cases, and a significant improvement in Harris hip scores (36 to 82).

Conclusions:

• The combination of DM cups with tantalum acetabular shells is effective for reconstructing large bone defects in revision THA.
• This approach successfully addresses postoperative instability and aseptic loosening.
• The technique does not appear to increase the re-revision rate, offering a viable solution for complex acetabular reconstructions.