10-Year Survival of Acetabular Reinforcement Rings/Cages for Complex Hip Arthroplasty

Ewers, Alexander; Spross, Christian; Ebneter, Lukas; Külling, Fabrice; Giesinger, Karlmeinrad; Zdravkovic, Vilijam; Erhardt, Johannes

doi:10.2174/1874325001509010163

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…They concluded that appropriate application of titanium cage can be effective to maintain stability and restore bone stock in the long term. [11][12][13] In this series we report up to 17 years of follow-up (average 7 years) of titanium reconstruction cages on 56 hips in 54 patients. To the best of our knowledge, this is the longest follow-up series of titanium cages in the literature.…”

Section: Discussionmentioning

confidence: 98%

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Titanium cage reconstruction of acetabular defects in revision hip arthroplasty results in favourable outcomes: up to 17 years follow-up

et al. 2019

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Introduction: Titanium cages are valuable implant solutions in management of severe acetabular defects during total hip revisions. We aimed to report clinical and radiological results of our cases in which we used titanium cages for reconstruction of acetabular defects. Methods: Patients who underwent titanium cage reconstruction and bone grafting for their acetabular defects with minimum 2-year follow-up are included to the study. Analysis of patient records, modified Hospital for Special Surgery (HSS) hip score and radiological examinations (plain X-rays) were evaluated. Acetabular defects are classified according to Paprosky’s classification. Kaplan Meier survival analysis was performed. Results: 71 hips of 67 patients (4 bilateral) aged between 26–83 (58.1 ± 14.9) years are followed up for 7.37 years ± 3.96 (2–17 years). 6 patients required revision surgeries at a mean of 2.5 ± 1.97 years. Kaplan Meier’s analysis revealed a survival rate of 91.9% and mean revision free duration was 15.8 ± 0.5 years. HSS scores of the patients before revision surgery yielded a mean score of 27.6 ± 4.72 (14–38). HSS scores at final follow-up showed a significant improvement at a mean score of 45.1 ± 7.22 (28–56) differences were statistically significant, p < 0.001). Discussion: Titanium cages are successful for restoring bone stock in severe acetabular defects. It is critical to pay attention to meticulous bone grafting of the presented defects and obtain good hip mechanics during cage insertion. Mechanical reasons are the leading cause of failure in long term but restoration of the bone stock and improvement in defect severity were regularly observed even in failed cages.

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Section: Discussionmentioning

confidence: 98%

“…Ewers et al 13 reported 77.7% survival at 10 years with trabecular titanium in acetabular revisions. Steno et al 14 review 81 hips revised with trabecular metal and reported 1 revision case at 38 months.…”

Section: Discussionmentioning

confidence: 99%

Titanium cage reconstruction of acetabular defects in revision hip arthroplasty results in favourable outcomes: up to 17 years follow-up

et al. 2019

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“…It is recommended to use a trabecular metal augment. Due to damage to the medial wall and column in type 3 (Table 1, Figure 1, Figures 7-9), it is imperative to use a cup-cage system to prevent protrusion [31]. Like a reinforcement cage.…”

Section: Discussionmentioning

confidence: 99%

Acetabular Defects of Hip Tuberculosis: Recommended Classification and Reconstruction in Hip Arthroplasty

Dang¹,

Khac²,

Xuan³

et al. 2022

OJO

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Background: This study aimed to propose a classification of acetabular defects in advanced-stage hip tuberculosis based on preoperative radiographs and intraoperative evaluation, thereby providing options for reconstructing each type of defect in hip arthroplasty. Materials and Methods: We conducted a prospective study with 45 patients with active hip tuberculosis at stage IV who were treated with a total hip replacement strategy. We collected the patients' acetabular defect data from preoperative radiographs and intraoperative observations. The defects were classified into types based on defect severity and reconstructive complexity. The hip replacement outcomes were evaluated at least 12 months after the operation. Results: The classification system includes three types: type I: localized or extensive defects inside the acetabulum, not affecting the acetabular rim, medial wall, or columns. Type II: extensive defects inside the acetabulum, affecting the acetabular rim or (and) medial wall. Type III: extensive defects inside the acetabulum, causing the medial wall and the acetabular column to lose function. Each type has a corresponding reconstruction. The outcome includes that 41/45 patients had excellent results; 3/45 patients had good results. The patients had good results due to nerve and muscle damage caused by tuberculosis not related to the acetabular defects. Conclusion: This is a simple, practical classification system of acetabular defects in hip tuberculosis. The outcome of hip reconstruction using this classification was excellent without any cases of dislocation or protrusion.

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“…The anti-protrusio cage is useful for treatment of severe acetabular rim and cranio-lateral border of the acetabulum bone defects and also in older patients owing to less acetabular support following osteoporosis. Moreover, with use of anti-protrusio cage, larger areas of acetabular loss could be bridged (17). There are several reports indicating the short-and long-term results of using the antiprotrusio cages in RTHA (15,(18)(19)(20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

The Midterm Results of Revision Total Hip Arthroplasty in Cases with Acetabular Defects: A Single-Center Case Series

Rasi¹,

Amrani²,

Abousaidi³

et al. 2018

J Orthop Spine Trauma

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Background: Revision total hip arthroplasty (RTHA) is one of the critical topics in the orthopedic surgery. In this single center case series, the revision treatment of cases with acetabular defects following total hip arthroplasty is reported. Methods: A total of 25 patients with acetabular defects were enrolled in this case series held in Imam Hossein Hospital, Tehran, Iran. The mean follow-up of patients was three years (24 -42 months). The illustrated data include a history of surgeries, underlying diseases, acetabular defect classification, surgery procedure, and pre-and post-surgery complications and managements, Harris hip score (HHS), leg length discrepancy (LLD). Results:The mean age of patients was 63.8 ± 10.45 years. A total of 14 patients had two previous surgeries, eight patients had three surgeries, and three patients had four previous surgeries. Classification of bone loss using AAOS showed that four patients had grade III and 21 patients had grade IV acetabular bone loss. The RTHA was done using anti-protrusio in 12 patients and large cups in 13 patients. The mean Harris hip score was 22.16 before RTHA, which was 80.6 after revision surgery. Before the operation, the mean leg length discrepancy was 38.84 mm, which was corrected after surgery to an average of 3.56 mm. Conclusions: Extensive evaluation of patients with acetabular defects before and during revision surgery leads to promising results. Larger studies evaluating the management strategy in patients with acetabular defects are needed.

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10-Year Survival of Acetabular Reinforcement Rings/Cages for Complex Hip Arthroplasty

Cited by 10 publications

References 19 publications

Titanium cage reconstruction of acetabular defects in revision hip arthroplasty results in favourable outcomes: up to 17 years follow-up

Titanium cage reconstruction of acetabular defects in revision hip arthroplasty results in favourable outcomes: up to 17 years follow-up

Acetabular Defects of Hip Tuberculosis: Recommended Classification and Reconstruction in Hip Arthroplasty

The Midterm Results of Revision Total Hip Arthroplasty in Cases with Acetabular Defects: A Single-Center Case Series

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