Management of Types III and IV Acetabular Deficiencies With the Longitudinal Oblong Revision Cup

Herrera, Antonio; Martı́nez, Amalia; Cuenca, Jorge; Canales, V.

doi:10.1016/j.arth.2005.08.026

Cited by 39 publications

(20 citation statements)

References 27 publications

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“…The use of high hip center arthroplasty has been associated with inferior results to arthroplasty with normal hip centers [13]. The survivorship with uncemented oblong cups is reportedly between 86% and 93% at mean followup durations between 6 to 9 years [8,10]. However, these studies involved contained and uncontained defects.…”

Section: Discussionmentioning

confidence: 99%

“…The remaining 53 patients (64 hips) had a mean age of 54 years (range, 28-83) at the time of surgery and a mean followup duration of 16 years (range, . Among the 53 patients, five patients died after a mean followup of 12 years (range, 7-15) and 10 were lost to followup after a mean followup of 12 years (range, [5][6][7][8][9][10][11][12][13][14][15][16][17]. There were 36 patients with more than 15 years followup and 16 patients with more than 20 years followup.…”

Section: Methodsmentioning

confidence: 99%

“…For Type 3 uncontained acetabular bone loss in which there is more than 30% but less than 50% acetabular bone loss, options for acetabular reconstruction include the use of impaction bone grafting [1,23], acetabular reinforcement ring [6,18], oblong cup [8,10], uncemented cup with high hip center [13], structural allograft (minor column or shelf graft) [20,25], and trabecular metal cup with augment [11,19,21,24]. Concerns have been expressed over early component migration and failure with impaction bone grafting in uncontained segmental acetabular bone defects.…”

Section: Introductionmentioning

confidence: 99%

“…The use of high hip center arthroplasty has not been widespread and has been associated with leg shortening, impinging instability, lower functional scores and survivorship. Morag et al [13] reported poorer survivorship (82% versus 94%), mean WOMAC scores (62 versus 70) and mean Harris Hip scores (70 versus 83) in patients with high hip centers ([ 35 mm above radiological teardrop, n = 31) compared to patients without high hip centers (n = 32) after revision at a mean followup of 10 years (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Studies reporting on the use of uncemented oblong cups were few with 90% midterm survivorships, but no long-term results [8,10].…”

Section: Introductionmentioning

confidence: 99%

“…Morag et al [13] reported poorer survivorship (82% versus 94%), mean WOMAC scores (62 versus 70) and mean Harris Hip scores (70 versus 83) in patients with high hip centers ([ 35 mm above radiological teardrop, n = 31) compared to patients without high hip centers (n = 32) after revision at a mean followup of 10 years (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Studies reporting on the use of uncemented oblong cups were few with 90% midterm survivorships, but no long-term results [8,10]. Trabecular metal cups and augments has been associated with survivorships around 97% at 3 years [11,19,21,24] while minor column acetabular allografts around 80% survivorship at 10 years with cup revision for aseptic loosening as endpoint [7,20,25].…”

Section: Introductionmentioning

confidence: 99%

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Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Lee

Raz²,

Safir³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background While acetabular structural allografts provide an important alternative for reconstructions, concerns remain with long-term graft resorption, collapse, and failure. Midterm studies of minor column (shelf) allograft suggest reasonable survival but long-term survival is unknown. Questions/purposes We therefore assessed long-term graft/cup survivorship, functional scores, radiographic resorption, and complications associated with minor column allograft. Methods We retrospectively reviewed 74 patients (85 hips) with a mean age of 54 years (range, 28-83 years) undergoing acetabular cup revision using a minor column allograft. A minor column allograft was used in uncontained acetabular bone defects sized between 30% and 50% of the acetabulum. Graft failure was considered to occur when the graft required revision with another graft, metal augment, reconstruction cage, or excision arthroplasty. The minimum followup was 5 years (mean, 16 years; range, 5.3-25 years). Results Twenty-three patients (27 hips) had rerevision for all causes at a mean time to rerevision of 6.9 years (range, 0.1-23). Fifteen grafts failed at a mean time-to-rerevision of 6.1 years (range, 0.5-23.2). The 15-and 20-year Kaplan-Meier survivorships were 61% and 55% for cups and 78% for grafts with rerevision for all causes as end point. With rerevision for aseptic loosening as end point, survivorships were 67% and 61% for cups and 81% for grafts. The mean modified Harris hip scores were 41 (range, 20-60) preoperatively, 73 (range, 40-95) at 1 year postoperatively and 73 (range, 26-93) at last followup.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Lee

Raz²,

Safir³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Use of morselized bone allograft in revision hip arthroplasty for massive acetabular defect: A systematic review and meta‐analysis

Cimatti,

Del Piccolo,

Dallari

et al. 2024

J. exp. orthop.

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PurposeMany treatment options are available for the revision of large acetabular defects. Debate continues as to which technique is most effective. This meta‐analysis aimed to determine the rates of failure of acetabular bone defects Paprosky type III or American Academy of Orthopaedic types III–IV treated with morselized allograft in association with cemented cup or cementless cup or reinforcement devices.MethodsThe US National Library of Medicine (PubMed/MEDLINE), EMBASE and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to 1 April 2024 utilizing keywords pertinent to total hip arthroplasty (THA), acetabular impaction bone grafting and revision THA. The main outcome measure was the 9‐year implant failure rate.ResultsThirty‐nine articles were eligible for inclusion in the current study. We found 41 treatment approaches that we grouped into three different treatment options: 1 = morselized allograft and cemented cup (10 studies); 2 =morselized allograft and cementless cup (nine studies); 3 = morselized allograft and device (22 studies). The overall implant failure rate was 2.1% (95% confidence interval [CI], 1.6%–2.8%) at a mean of 9.2 years. There was no significant difference in failure rates between different treatment options (1.6% [95% CI, 0.9%–2.6%]) for morselized allograft and cemented cup; 2.1% (95% CI, 1.4%–3.2%) for morselized allograft and cementless cup; 2.5% (95% CI, 1.7%–3.7%) for morselized allograft and device) between the three different types of treatment (heterogeneity between groups p = 0.351).It was determined that the number one cause of failure was aseptic loosening (80.5%), followed by infection (13.1%) and dislocation (6.4%). THA with reinforcement devices has a higher incidence of infection (3.6 vs. 0.7%, p = 0.001) and dislocation (1.4 vs. 0.6%, p = 0.010) than THA with a cemented cup.ConclusionsThe use of morselized allograft in hip revision of large acetabular defects has low implant failure rates, independently of the associated type of implant. Reinforcement devices increase the risk of re‐revision for infection and dislocation.Level of EvidenceLevel III.

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Hip and Knee Replacement

Agarwal

2021

Current Orthopaedic Practice

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Management of Types III and IV Acetabular Deficiencies With the Longitudinal Oblong Revision Cup

Cited by 39 publications

References 27 publications

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Long-term Results for Minor Column Allografts in Revision Hip Arthroplasty

Use of morselized bone allograft in revision hip arthroplasty for massive acetabular defect: A systematic review and meta‐analysis

Hip and Knee Replacement

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