Reconstruction of a hip socket using trabecular metal components

Abstract

Introduction. Fixation of the acetabular component in patients with bone defects of the acetabulum is a difficult task due to the insufficient quantity and poor quality of the remaining bone tissue. During the last few years in our country in arthroplasty of the acetabulum with severe bone defects were actively used implants made of trabecular metal. Purpose of study: was to evaluate short-term clinical and radiological results of the usage of trabecular metal components in patients with bone defects in revision and primary hip replacement. Patients and methods. 59 surgeries were performed using components of trabecular metal, 53 of them were performed on the instability of the hip prosthesis, 2 - post-traumatic hip dysplasia, 2 - aseptic necrosis of the femoral head, 2 - high dislocation of the femoral head. Among the operated there were 37 women and 22 men, the average age was 58.2±19.9 years. According to the Paprosky classification, defects in 12 cases corresponded to type IIA, in 14 - type IIB, in 6 - type II, in 19 - type IIIA, in 7 - type IIIB. The structural features of these implants, made of tantalum in a carbon skeleton with uniform porosity, similar to the structure of bone tissue, provide an increased coefficient of friction, thereby contributing to the rapid growth of bone tissue in the implant structure. Results. The average follow-up period was 14 months. The average preoperative assessment of the hip joint by Harris Hip Score (HHS) was 43 points (from 14 to 86). After surgery, the average HHS improved to 88.7 (69 to 100). 1 patient had hemorrhagic discharge after surgery. On the 7th day an audit was performed. In 2 cases, paresis of the peroneal portion of the sciatic nerve developed after surgery. There were no cases of recurrent dislocations, deep infection, pulmonary embolism or death as a result of operations. Conclusion. Taking into account the mechanical properties, tantalum implants allow to achieve a stable primary fixation with the restoration of the center of rotation of the hip joint and eliminate the risks associated with the use of allografts. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

Early results of revision acetabular endoprosthetics using individual designs

“…При реконструкции вертлужной впадины используются различные конструкции и методы восстановления, к их числу относятся ревизионное эндопротезирование с установкой вертлужного компонента в высоком центре ротации [14]; установка полусферических вертлужных компонентов больших размеров (jumbo cups) [15]; классический вариант реконструкции с использованием антипротрузион ных колец в сочетании с костной пластикой [16]; техника «кольцо в чашке» (cup-cage) [17]; реконструкция с применением высокопористых компонентов из трабекулярного тантала [18,19]. Однако состояние костной ткани, выраженность и геометрия дефекта требуют технических решений по адаптации ложа вертлужной впадины под серийные компоненты (чашки, аугменты) [20][21][22].…”