Continued Good Results With Modular Trabecular Metal Augments for Acetabular Defects in Hip Arthroplasty at 7 to 11 Years

Abstract

Background Reconstruction of large acetabular defects remains a substantial challenge in hip arthroplasty. There remains a paucity of data on the long-term results of acetabular trabecular metal augments. Questions/purposes The purpose of this study was to assess the survivorship, clinical outcomes, restoration of center of rotation of the hip, and radiological signs of component fixation of trabecular metal augments in the context of reconstruction of acetabular defects. Methods Between 2002 and 2005, we performed 56 revision (n = 53) and primary (n = 3) THAs using trabecular metal augments in combination with a trabecular metal acetabular component. Of the 56 patients, 16 (29%) died during followup. Of the 40 surviving patients, 37 (93%) had complete radiological followup, 23 (58%) had complete outcome questionnaire followup, and 17 (42%) provided partial questionnaire responses in the clinic or over the telephone. Median followup was 110 months (range, 88-128 months). During that period, we used these implants when preoperative templating indicated that an augment would be required to achieve acetabular implant stability with restoration of the hip center of rotation. We also chose during surgery to use an augment when we could not achieve a stable acetabular trial component without one. The combination of trabecular metal augments and trabecular metal shells was used in 18% (53 of 292) of our acetabular revisions during that time. Survivorship, functional outcome (WOMAC and Oxford hip score), health status (SF-12), and osseointegration according to the criteria of Moore and presence of radiolucencies were determined.

Tritanium acetabular wedge augments: short-term results

“…The overall experience with the tritanium acetabular wedge augment in this short follow-up case series report has being excellent, as no early failures have been detected in any of the patients in our study. This reflects findings in literature on other acetabular augments, as early followup with trabecular metal augments demonstrated improved clinical outcomes and low revision rates (21)(22)(23), and midterm follow-up with these same acetabular augments report 92% survivorship at ten years (12). Other trabecular titanium augments have shown less robust results, but have demonstrated improved functional scores at a minimum of 2-year follow-up (13).…”

“…Whether the cause of such defects is DDH or osteolysis present in a failed THA, reconstruction needs to be addressed accordingly (2-4). Technology has evolved from the use of structural allografts (5,6) to the use of cages (7,8), jumbo cups (9-11), and acetabular augments (12,13), depending on the size and location of the defect. Superiority of one over the others has not been reached (20).…”

“…Due to lack of resources, the initial treatment for these types of defects was structural allografts (5,6). Later on, newer technology allowed the use of cages (7,8), jumbo cups (9-11), and most recently, acetabular augments have been added to our armamentarium (12,13). All these treatment options have been used for filling acetabular defects, but consensus for superiority of one method over others has not been reached.…”

Trabecular Metal Augments for the Management of Paprosky Type III Defects Without Pelvic Discontinuity

“…Although some authors investigated the use of TM cups and augments in this setting [3,[8][9][10][11][12][13][14][15][16][17], they performed studies including patients with different types of bone defects, ranging from Paprosky grade IIA to grade IIIB with pelvic discontinuity, who underwent revision surgery using TM acetabular cups with or without TM augments. Therefore, data arising from these studies refer to non-homogenous populations managed with different surgical techniques.…”

Endoprothese bei Dysplasiecoxarthrose

“…Deshalb ist es naheliegend, auch bei höhergradigen Dysplasiecoxarthrosen mit ähnlichem Zerstö-rungsmuster der Pfanne metallische Augmente zur kranialen Abstützung zu nutzen. Die überwiegende Zahl der bislang vorliegenden Anwendungsbeobachtungen beschreibt die Ergebnisse von trabekulären Metallkonstrukten aus Tantal in der azetabulären Revisonschirurgie und darin sind auch vereinzelt Fallbeschreibungen einer Anwendung bei primären Pfannendefekten enthalten [72]. In einer kürzlich erschienenen Publikation, die sich auf die alleinige Versorgung von Dysplasiecoxarthrosen bezieht, wird über die Verwendung zementfreier Pfannensysteme berichtet, die eine Kombination mit trabekulären Augmenten erlauben [37].…”