Revision Total Hip Arthroplasty Using Tantalum Augment in Patients with Paprosky III or IV Acetabular Bone Defects: A Minimum 2-year Follow Up Study

Abstract

PurposeThe purpose of this study is to report the short-term outcomes of revision total hip arthroplasty (THA) using tantalum augments in patients with severe acetabular bone defects.Materials and MethodsWe retrospectively analyzed 15 revision THAs performed in 15 patients using tantalum augments between June 2010 and December 2013. Acetabular bone defects were Paprosky type IIIA in 7 hips, type IIIB in 7, and type IV in 1. The causes of revision surgery were aseptic loosening in 12 hips and deep infection in 3. Revisions were first in 1 hip, second in 3, and third in 11. Six patients were male and 9 female with a mean age of 59 years (range, 48-75 years). Mean follow-up was 29 months (range, 24-48 months).ResultsMean Harris hip score was improved from 34 points (range, 12-54 points) preoperatively to 84 points (range, 38-90 points) at final follow-up. On the final follow-up radiographs, there were 12 hips (80.0%) with stable fixation of the acetabular cup, 2 (13.3%) with secondary stability after mild acetabular protrusion, and 1 (6.7%) with radiolucency around the acetabular cup without mechanical symptoms. Complications included one patient with acute hematogenous infection managed by surgical debridement and long-term antibiotic therapy. There were no cases with nerve palsy or dislocation during the follow-up period.ConclusionThe present study showed satisfactory clinical and radiographic outcomes of revision THA using tantalum augments due to severe acetabular bone defects of Paprosky type III or IV at a minimum follow-up of 2 years.

Three-Dimensional Models in Planning of Revision Hip Arthroplasty with Complex Acetabular Defects

“…Treatment of patients with complex acetabular defects is a very difficult problem. 7 8 In cases of severe bone defects, we should achieve stable fixation of the acetabular component and restore the hip center. 9 The most optimal way is the biologic fixation with good primary stability and secondary osteointegration.…”

“…Many authors report good results of tantalum augments and cups with tantalum coating. 8 10 11 12 13 14 Furthermore, there are some publications about custom-made triflange components for complex acetabular revision. 4 5 6 …”

Mid-Term Outcomes of Revision Hip Arthroplasty with Acetabular Augments

“…Тантал все чаще используется в ревизионном эндопротезировании ТБс, особенно при наличии значительных костных дефектов вертлужной впадины. в недавних исследованиях зарубежных коллег сообщается о хороших краткосрочных результатах операций с применением танталовых аугментов [7][8][9][10]. все проанализированные операции выполнялись под руководством одного хирурга.…”

“…за рубежом танталовые аугменты были введены в клиническую практику еще в 1997 г. Известно, что высокая степень пористости и шероховатая микротекстура поверхности танталовых аугментов способствуют лучшей остеоинтеграции и первичной стабильности при имплантации [25]. в ряде исследований показаны хорошие и отличные результаты использования ацетабулярных аугментов при ревизионном эндопротезировании ТБс [1,[6][7][8][9][10]23]. I. elganzoury и a.a. Bassiony вели наблюдение за 18 пациентами, которым было выполнено ревизионное эндопротезирование ТБс с использованием трабекулярных металлических чашек и аугментов из тантала [8].…”

An alternative treatment option for Paprosky Type IIIb acetabular defect using multiple tantalum wedges – A case report

“…The appropriate surgical technique and implant choice mainly depends on the severity of bone loss and location of the defect. 2,3 Contained defects allow the use of a morcellised allograft in combination with a conventional cemented or cementless acetabular component. 4e6 Minor column defects with remaining vertical support can be treated by minor column allograft combined with a conventional component, an oblong implant or a jumbo cup.…”