Management of Acetabular Bone Loss in Revision Total Hip Arthroplasty

Abstract

Most acetabular revisions can be managed with a hemispherical component with screw fixation. Areas of segmental bone loss that preclude acetabular component stability may be managed with structural allograft or second-generation porous metal augments. Acetabular cages have a limited application but can be a useful tool in the management of massive bone loss and pelvic discontinuity.

Additively manufactured porous tantalum implants

“…It has proven bone ingrowth both in animal studies [29,[43][44][45] and retrievals from clinical cases [46,47], 5 although some publications mention issues like implant failure and the brittle deformation behavior of TM [48][49][50]. Furthermore, the mechanical properties of TM are close to those of human bone [51][52][53][54] and most uses of TM can be found in hip [55][56][57][58][59][60][61][62], knee [63][64][65][66][67], spinal [40,[68][69][70] and other orthopedic applications [71]. Despite the clinical success of TM, no other implant manufacturers use Ta as raw material for orthopedic implants.…”

Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty

“…In fact, aseptic loosening is the most common reason for revision THA (2)(3)(4). Deficiency of acetabular bone stock is usually caused by osteolysis due to wear of implants, stress shielding from an excessively stiff implant, loosening and migration of the cup, or infection (5,6). The loss of bone stock poses a challenge for revision THA, but there are different options to overcome the problem.…”

Tritanium acetabular wedge augments: short-term results

“…Technology has evolved from the use of structural allografts (5,6) to the use of cages (7,8), jumbo cups (9-11), and acetabular augments (12,13), depending on the size and location of the defect. Superiority of one over the others has not been reached (20). Allografts can reabsorb or fail to integrate (14), and continue to be a risk for transmission of infections (15).…”