Complete acetabular cup revision versus isolated liner exchange for polyethylene wear and osteolysis without loosening in cementless total hip arthroplasty

Abstract

We found no differences in acetabular osteolysis progression, fixation failure, or complication between the cup revision and retention groups. Therefore, isolated liner exchange without cup extraction in cases of osteolysis that includes a well-fixed and well-positioned shell could be considered as a viable treatment option.

Revision Total Hip Arthroplasty with Retained Acetabular Component

“…Lie et al reported an 11.8% rerevision rate following complete revision of a fixed acetabular component 9 ; Talmo et al reported a 15% rate 10 . Other authors have demonstrated similar failure rates following liner exchange and complete acetabular revision 17,18 . Restrepo et al compared thirty-six patients who had undergone polyethylene exchange with thirty-one patients who had had revision of a fixed acetabular component and found similar rerevision rates (8% compared with 3%, p = 0.62) 17 .…”

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

“…Nine articles remained after 460 were screened. One additional article was identified during the review of the bibliographies from the nine articles, resulting in a total of 10 articles for this topic [5,6,19,21,25,31,36,39,40,45] (Fig. 1).…”

“…The most frequently reported procedures for treating hip polyethylene wear with or without osteolysis were cup revision and isolated polyethylene exchange (Table 1) [5,6,19,21,25,31,36,39,40,45]. The mean followup in these articles ranged from 2.5 to 4.8 years.…”

“…When a cup revision was done to treat wear, a common mechanism of failure leading to rerevision was aseptic acetabular loosening reported to occur between 0.4 and 2.7 years after the initial revision [25,39,40]. Recurrent dislocation was also reported as a failure mode in two articles [5,40].…”

“…Six articles reported recurrent dislocation rerevision rates from 0% to 8% [5,6,19,21,25,31]. Two of the articles reported a time frame for these rerevisions of 2.3 to 6.5 years [6,21].…”