Revision of the Acetabular Component of a Total Hip Arthroplasty with a Massive Structural Allograft. Study with a Minimum Five-Year Follow-up*

Garbuz, D S; Morsi, Elsayed; Gross, Allan E.

doi:10.2106/00004623-199605000-00008

Cited by 216 publications

(100 citation statements)

References 14 publications

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“…The survivorship of revision cementless acetabular components and roof/reconstruction rings in this series was similar. The latter is comparable with other series and all diagnoses (42%-87% at 5-10 years followup) [10,28,33].…”

Section: Discussionsupporting

confidence: 91%

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Goodman¹,

Hwang²,

Imrie³

2013

Clin Orthop Relat Res

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Background Revision total hip arthroplasty (THA) in patients with juvenile idiopathic arthritis (JIA) is challenging as a result of the patient's young age, systemic disease, multiple affected joints, small proportions, and bone loss. The intermediate-to long-term results of these surgeries remain unknown. Questions/purposes The purpose of this study is to determine the (1) functional outcomes; (2) surgical complications; and (3) frequency of reoperation or revision after revision THA for JIA. Methods We reviewed the records of all patients from one center who underwent revision THA for JIA who had a minimum of 5 years of followup (mean, 9 years; range, 5-19 years). This resulted in a series of 24 revision THAs in 15 patients. All patients were Charnley Class C. Age at revision averaged 35 years (range, 21-53 years). The 20 acetabular and 12 femoral revision components included 15 cementless cups, five reconstruction/roof rings with a cemented cup, and four cemented and eight cementless femoral stems. Results The Harris hip scores improved from 54 (range, 34-85) to 77 (range, 37-100) (p \ 0.001). Complications included two proximal femoral fractures associated with severe osteolysis and one sciatic nerve palsy in a patient with severe acetabular deficiency. A total of seven hips (29%) required reoperation or revision surgery, including three for infection (one early and two late) and four for mechanical loosening. Conclusions Revision THA in JIA is very challenging owing to patients' small proportions and compromised bone stock. The intraoperative and early complication rates are relatively high. Prognosis for long-term survivorship is guarded; limiting factors include periprosthetic osteolysis associated with older implants that used conventional polyethylene and cemented stems.

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Section: Discussionsupporting

confidence: 91%

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Goodman¹,

Hwang²,

Imrie³

2013

Clin Orthop Relat Res

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“…Compared to other studies [7,8,9,17,20,21] we had nearly twice as many women, and our patient population was almost 10 years older. Recent papers [24,25,26] have, however, patient groups comparable to ours.…”

Section: Discussionmentioning

confidence: 86%

Revision cup arthroplasty using Burch-Schneider anti-protrusio cage

Koeveringe

Ochsner

2002

International Orthopaedics

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From 1986 until 1995 we used the BurchSchneider anti-protrusio cage in 31 patients (33 hips) and followed the patients for 5 years. Five patients died within the 5-year follow-up. Clinical outcome listed an average Harris hip score of 71/70/66 points after 1, 2 and 5 years respectively. One patient had a revision due to late-onset haematogenous infection. We found cup migration in nine patients. Migration was self-limiting in three cases and in two there was no bony graft ingrowth. Screw breakage was seen in one case. All migrated cages showed a higher rotational centre than cages without migration.Résumé Entre 1986 et 1995 nous avons utilisé l'anneau anti-protrusion de Burch Schneider chez 31 malades (33 hanches) qui ont été suivis 5 années. Cinq malades sont morts dans ce délai. Le résultat clinique donne un score moyen de Harris de 71/70/66 points après respectivement 1, 2 et 5 années. Un malade a eu une révision à cause d'une infection hématogène à début tardif. Nous avons trouvé une migration de la cupule chez 9 malades. La migration s'était limitée spontanément dans trois cas. Dans deux cas il n'y avait aucune réhabitation de la greffe. Une rupture de la vis a été vue dans un cas. Toutes les cupules ayant migré avaient un centre rotationnel plus haut situé que les cupules sans migration.

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“…The results of minor column defects (\ 50% of implanted component supported by graft) indicate that survivorship of 80% at a mean followup of 10 years with aseptic loosening as the endpoint may be achieved [42], falling to 55% at 20 years [22]. When a major column graft is used (typically when [ 50% of the implanted component is supported by graft), survivorship of 55% at a mean followup of 7 years has been shown [14]. The use of bilobed acetabular components has been associated with failure rates of 24% at a mean followup of less than 4 years [7].…”

Section: Discussionmentioning

confidence: 99%

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

Whitehouse

Masri

Duncan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

103

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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.

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Revision of the Acetabular Component of a Total Hip Arthroplasty with a Massive Structural Allograft. Study with a Minimum Five-Year Follow-up*

Cited by 216 publications

References 14 publications

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Revision cup arthroplasty using Burch-Schneider anti-protrusio cage

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

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