A technique to remove a well-fixed titanium-coated rm acetabular cup in revision hip arthroplasty

Abstract

A major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup, because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss and compromises reimplantation of a new socket.In the following case report, we removed a well-fixed polyethylene titanium-coated RM acetabular cup with 20 years of follow-up, by significant wear of the polyethylene layer. The isoelastic femoral stem was also removed by mechanical failure.We report a technique for removal of the cementless acetabular cup using powered acetabular reamers. The RM cup was sequentially reamed and when the polyethylene layer was thin enough, the remaining cup was removed easily by hand tools. The acetabular bone stock is preserved and the risks of bone fractures and bleeding are minimized. To our knowledge, these principles were applied only in cemented cups.We have used this technique in 10 cases with excellent results and no complications were noted. This is a simple, reproducible, non-costly, non-timing consuming, safe and successful technique to remove well-fixed titanium-coated RM acetabular cups.

A simple technique to remove well-fixed acetabular components in revision of total hip arthroplasty

“…In some cases, infections in bone-cup interface make acetabular components removing easily, because of bone stock reducing and components loosening. But removing stable acetabular components can be challenging, inefficient, and reducing bone stock [7] . The main concern regarding revision is acetabular bone loss during extracting well-fixed acetabular components, which may occur as a factor of the primary procedure or revision itself [8] …”

A technique to remove a stable all-polyethylene cemented acetabular liner in revision hip arthroplasty: A case report

“…Well-fixed acetabular component may be removed in cases of recurrent dislocations by malposition of the acetabular prosthesis. Removal of a stable cemented acetabular component in revision total hip arthroplasty can be challenging, time consuming, and potentially detrimental to the remaining host bone [3,4] .…”

“…On the other hand, if this technique fails it is possible to carry out others methods for the extraction of the acetabular implant. The removal process can be performed with sequential acetabular reamers to thin the liner, and allow easier extraction of the implant [4] .…”

A Simple Technique to Remove Well Fixed Porous Cementless Acetabular Component in Revision Total Hip Arthroplasty

“…of cementless acetabular components. Some of these techniques are common to both cemented and press-fit acetabular components, while others are specific to one or the other [1][2][3][4][5].…”