Highly Porous Metal Revision Cup With a Cemented Dual Mobility Bearing Reduces Instability Following Complex...

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Arthroplasty Research

Background:

• Complex acetabular reconstructions present challenges, particularly regarding instability.
• Large acetabular defects require specialized implant solutions for successful revision total hip arthroplasty (THA).

Purpose of the Study:

• To evaluate the efficacy of a highly porous metal cup with a cemented dual mobility bearing in complex acetabular reconstructions.
• To assess the incidence of instability and implant survivorship, including aseptic loosening and all-cause revision.

Main Methods:

• Retrospective review of a prospectively collected joint registry for revision THAs with major acetabular defects (Paprosky 3A/3B, pelvic discontinuity).
• Utilized highly porous tantalum hemispherical cups with cemented stainless-steel dual mobility liners.
• Follow-up included assessment of dislocations, aseptic loosening, and all-cause reoperation; minimum 2-year follow-up.

Main Results:

• No dislocations were observed in the cohort of 33 revision THAs.
• Overall implant survivorship was 95%, with low rates of aseptic loosening and all-cause revision.
• Significant improvements in clinical outcome scores (HHS, WOMAC, SF-12) were noted postoperatively.

Conclusions:

• Cemented dual mobility liners within highly porous metal shells effectively mitigate instability in complex acetabular reconstructions.
• This approach demonstrates favorable short-term survivorship and low revision rates for major acetabular defects.