A Registry Study on Acetabular Revisions Using Jumbo Cups: Do We Really Need a More Complex Revision Strategy?

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Biomaterials

Background:

• Rising total hip arthroplasty (THA) revisions due to cup failure, particularly aseptic loosening and infection.
• Jumbo cups (JCs) are used to manage bone loss in revision THA, enhancing bone contact and osteointegration.
• Need for long-term outcome data on JCs in acetabular revision surgery.

Purpose of the Study:

• Evaluate the 20-year outcomes of acetabular revision arthroplasty using jumbo cups (JCs).
• Report overall survivorships and complications leading to re-revision.
• Analyze surgical strategies employed in re-revision cases.

Main Methods:

• Large regional registry cohort study of revision THA with cementless JCs (≥62mm women, ≥66mm men) from 2000-2020.
• Excluded iliac fixation cups; collected data on demographics, indications, components, fixation, failure causes, and reinterventions.
• Evaluated 541 JCs, with primary revision indications being aseptic loosening (54.5%) and total aseptic loosening (32%).

Main Results:

• Jumbo cup survival rates: 92.5% at 5 years, 85.8% at 10 years, 81.5% at 15 years.
• Top failure causes: aseptic loosening (40%), total aseptic loosening (17.1%), and septic loosening (12.8%).
• Revisions included acetabular cup revision (54), component explantation (11), and insert/head revision (5).

Conclusions:

• Registry data supports JCs as a viable option for revision THA with excellent 15-year survival.
• JCs demonstrate acceptable failure rates in complex acetabular reconstructions.
• JCs offer a surgically simpler alternative to cages, bone grafts, or augments.