Use of cementless acetabular component with a hook and iliac flanges in revision arthroplasty for massive acetabular defect

Kim, Ki-Choul; Ha, Yong‐Chan; Kang, Bun-Jung; Lee, Yong Seuk; Ji, Hyung-Min; Koo, Kyung‐Hoi

doi:10.1007/s00776-011-0174-8

Cited by 10 publications

(5 citation statements)

References 33 publications

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“…Achieving primary stability and restoring centre of rotation during revision THA in the presence of large acetabular defects could be a very tough challenge, several reconstruction techniques 6–10 as previously mentioned, were described with interesting results. Due the encouraging results obtained using porous tantalum, 4 different materials with similar biomechanical and biological properties have been introduced into the biomedical field.…”

Section: Discussionmentioning

confidence: 99%

“…Paprosky classification is based on the integrity and the capacity of providing support of anatomical structure; Type IIIa (superolateral migration >2 cm) and Type IIIb (superomedial migration >2 cm) are considered severe acetabular defects. These defects can be reconstructed using different surgical techniques: 4 antiprotrusio-cage, 5,6 impaction bone grafting, 7 hemispherical cups, 8 and custom triflange cups. 9,10 The most encouraging mid-term clinical results were obtained using porous tantalum implants while the antiprotrusio-cage is still the most frequently used implant.…”

Section: Introductionmentioning

confidence: 99%

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Trabecular Titanium acetabular cups in hip revision surgery: mid-term clinical and radiological outcomes

Meo¹,

Cacciola

Bellotti

et al. 2018

HIP International

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Introduction: Severe acetabular bone loss during revision hip arthroplasty can be restored with different surgical techniques. Best results have been observed using porous tantalum cementless cups. Trabecular Titanium (TT) cups were designed to reproduce the structure, mechanical and biological characteristics of trabecular bone. Few clinical studies have been published with these cups. The aim of this study is to evaluate the clinical and radiological outcome of patients with large acetabular defects (Paprosky IIb or higher) revised using TT cups. Materials and methods: 64 consecutive patients who underwent revision for total hip arthroplasty (THA) between 2011 and 2015 at our institution were enrolled. All were classified as Paprosky IIb, IIc, IIIa and IIIb. Periprosthetic joint infections and fractures were not included in this study. Radiographic and clinical (Harris Hip Score (HHS)) outcomes were evaluated. Kaplan-Meyer survivorship curve was performed. Results: Complete data of 58 patients (mean follow-up 48.3 months) were analysed. 6 patients underwent a further revision (10.3%). Causes of re-revision were instability (5.2%), infection (3.4%) and aseptic loosening (1.7%). No radiolucent lines or signs of migration were observed. Survivorship was 94.8%. HHS Improved from a mean of 36.5-83.7. Discussion: TT cups demonstrated encouraging results at mid-term follow-up. Cup modularity represented a helpful tool to restore hip rotation centre and to reduce the risk of dislocation. The capacity of trabecular titanium to induce bone growth and the versatility of modularity, make the Delta TT System a very useful aid for surgeons who are more frequently faced with complex revision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trabecular Titanium acetabular cups in hip revision surgery: mid-term clinical and radiological outcomes

Meo¹,

Cacciola

Bellotti

et al. 2018

HIP International

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“…12 In this case, contributing factors included poor existing bone stock, the small number of screws used in the ischial and ilial flanges, the older screw design with closely spaced shallow threads leading to reduced screw pullout strength and failure to medialise the cup as much as possible to improve hip biomechanics. 13 The bioengineers as well as the surgical team looked for different solutions to enhance fixation while addressing the existing defect: after filling the lack of bone with bone pasta (demineralized bone matrix (DBM) mixed with processed bone marrow that we harvested from the ipsilateral iliac crest), the cup was positioned with abduction 40° and anteversion 20°. Superior augment was Ø 65 mm as was the infer ior one.…”

Section: Discussionmentioning

confidence: 99%

Customised three-dimensional printed revision acetabular implant for large defect after failed triflange revision cup

Zanasi

Zmerly²

2020

BMJ Case Rep

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Aseptic loosening is the most common cause for total hip arthroplasty revision. Acetabular cup revision is a significant challenge in the presence of a large bone defect. One of the options for cup revision in the presence of a large bone defect is the recently introduced customised three-dimensional (3D)-printed reconstruction. We present the case of a 68-year-old woman successfully treated with a customised revision acetabular implant for the failure of triflange cup in the presence of large acetabular defect. The modern orthopaedic surgeon must have full knowledge of customised 3D-printed reconstruction to have as a reserve solution for difficult hip revision surgery.

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“…The acetabular component consisted of a cemented hemispherical titanium alloy cup, an acetabular hook, and three iliac flanges (revision cup system, Lima corporate spa, Udine, Italy). Although this cage is first-generation production from Lima corporate spa, it is still used popularly in China because most people could not afford the second-generation production although it is more advanced because of a snap-in locking mechanism of the liner [ 17 ]. A posterolateral approach was used in all hips.…”

Section: Methodsmentioning

confidence: 99%

The use of morselized allografts without impaction and cemented cage support in acetabular revision surgery: a 4- to 9-year follow-up

Ding

Mao

et al. 2015

J Orthop Surg Res

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BackgroundAcetabular revision arthroplasty with major bone loss is one of the most difficult operations in orthopedic surgery. The goal of the study was to evaluate midterm clinical results of the use of morselized allografts with cemented cage support in revision total hip replacement.MethodsWe identified 28 patients (29 hips) at an average follow-up of 73 months. Harris Hip Scores (HHS) were assessed before and after surgery. Pre- and postoperative radiographs were evaluated for restoration of the center of rotation, component migration, and graft incorporation.Results and discussionAt follow-up, the mean HHS improved from 34 (range, 20–45) to 80 (range, 71–98) points. None of the components had been re-revised. On average, the revised hip center of rotation was improved significantly. Incorporation of the graft was complete in 23 hips. The midterm result of cage reconstruction with morselized bone allograft is relatively better than other studies using a similar cage construction. We believe we have three special modifications of this reconstruction technique that are beneficial for bone incorporation.ConclusionsThese data confirm that acetabular reconstruction using morselized allografts and cemented acetabular cages is effective in the midterm as a treatment for acetabular loosening with massive bone deficiency.

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Use of cementless acetabular component with a hook and iliac flanges in revision arthroplasty for massive acetabular defect

Cited by 10 publications

References 33 publications

Trabecular Titanium acetabular cups in hip revision surgery: mid-term clinical and radiological outcomes

Trabecular Titanium acetabular cups in hip revision surgery: mid-term clinical and radiological outcomes

Customised three-dimensional printed revision acetabular implant for large defect after failed triflange revision cup

The use of morselized allografts without impaction and cemented cage support in acetabular revision surgery: a 4- to 9-year follow-up

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