Mid-Term Outcomes of Revision Hip Arthroplasty with Acetabular Augments

Abstract

acetabular defects are a major obstacle to achieving good outcomes after revision hip arthroplasty. one way to deal with this problem is to use acetabular augments. We aimed to describe mid-term outcomes of revision hip arthroplasty using acetabular augments. Materials and methods. We analyzed 85 cases (83 patients) of revision hip arthroplasty using acetabular augments performed during 2012-2018 period: 53 women and 30 men with average age of 57±13 years (25-79). Distribution of acetabular defects was: 51 cases-Paprosky IIIa, 17 cases-Paprosky IIIB, 12 cases-Paprosky IIB, 5 cases-Paprosky IIc. 14 patients had chronic pelvic discontinuity. aseptic loosening was indication for the operation in 83 cases, periprosthetic hip fracture-1, dislocation-1. The amount of previously undregone ipsilateral hipsurgeries was 1 in 35 cases, 2 in 25 cases, 3 and more in 25 cases. average follow-up period was 38±19 months (1-79). Results. The average HHS score improved from 37±7 preoperatively to 73±9 after 3 months and to 80±11 after 12 months postoperatively (p = 0.001). average VaS score improved from 7±2 preoperatively to 4±1 after 3 months and to 3±1 after 12 months postoperatively (p = 0.001). Stable acetabular fixation was achieved in each case according to x-ray findings at final follow-up. However, radiolucent lines were present around the cup in 10 cases (11.8 %) followed by no clinical evidence of aseptic loosening. Hip center of rotation was restored from 26.40±18.38 mm (4-75) preoperatively to 4.78±5.02 mm (0-20) postoperatively relatively to 0 point. complications manifested in 9 out of 85 cases (10,6%). Distribution of complications was: periprosthetic joint infection in 6 cases, recurrent dislocation-2, periprosthetic hip fracture-1.7 patients required implant removal and exchange. Conclusions. Good mid-term outcomes can be achieved using acetabular augments during hip revision surgery in setting of acetabular defects. acetabular augments are a reliable option in case of Paprosky IIIB, IIIa defects and chronic pelvic discontinuity, providing good mechanical stability.