Porous cementless cups combined with trabecular metal augments in revision hip arthroplasty: mid-term outcomes

Reconstruction of acetabular bone defects represents one of the most technically demanding aspects of revision total hip arthroplasty. Although numerous implant options and surgical techniques have been proposed, porous acetabular components combined with trabecular metal augments have gained widespread acceptance as a contemporary reconstructive strategy. The present study aims to assess implant survivorship and to report mid-term clinical and radiographic outcomes associated with this technique. We identified 69 revision total hip arthroplasties (69 patients) performed at the Department of Joint Arthroplasty of the Priorov National Medical Research Center of Traumatology and Orthopedics between January 2016 and June 2022, using porous acetabular cups in combination with trabecular metal augments. Among these patients, 46 (66.6%) were female and 23 (33.4%) were male. The mean patient age was 59.9 years (± 12.4), with a mean follow-up duration of 4.9 years (± 1.78), ranging from a minimum of 2.6 years to a maximum of 9 years. Functional outcomes were assessed using the Harris Hip Score (HHS), Visual Analogue Scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), while implant survival was evaluated using Kaplan-Meier analysis. The overall HHS significantly improved from a preoperative mean of 32.9 (± 9.8) to a postoperative mean of 86.7 (± 4.9). VAS scores decreased from 8.1 (± 0.5) to 3.4 (± 0.5), WOMAC scores decreased from 61.3 (± 4.7) to 24.7 (± 2.4), indicating favorable clinical and functional outcomes (p < 0.00001 for each scale). Kaplan-Meier survival analysis demonstrated a 9 years (109.7 months) cumulative implant survivorship rate of 98.55%. The results indicate that porous acetabular cups combined with trabecular metal augments represent an effective option in revision hip arthroplasty, demonstrating excellent mid-term outcomes in terms of both implant survivorship and functional improvement.