Mid-term results of revision total hip arthroplasty using the oval-shaped uncemented Trč-Cingr cup

Šťastný, Eduard; Trč, Tomáš; Handl, M; Kos, Petr; Kautzner, Jakub; Philippou, Theodoros; Lisý, Jiří

doi:10.1007/s00264-013-2269-7

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…Midterm results showing reliable primary fixation and computed tomography-documented osseointegration with specially designed oblong revision cups and good clinical results have been published recently [18].…”

Section: Discussionmentioning

confidence: 99%

Acetabular revision arthroplasty using trabecular titanium implants

Šteňo

Kokavec

Nečas

2014

International Orthopaedics (SICOT)

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Purpose The aim of this study was to evaluate early results of acetabular revisions of total hip replacement using fully cementless trabecular titanium (TT) acetabular modular implants (Delta Trabecular Titanium, Limacorporate, Udine, Italy). Methods Between March 2009 and May 2012 TT was used in 81 revisions. The mean age at the time of revision was 68 years (32-84 years). There were nine patients revised for type 1, 11 for type 2A, 27 for type 2B, six for type 2C, 15 for type 3A and 13 for type 3B acetabular defects according to the Paprosky classification. Frozen morselised bone allografts were used in 53 cases and bulk structural allografts in three cases. Clinical evaluations were made using a modified functional Merle d'Aubigné-Postel score. The mean follow-up period was 38.14 months (24-62 months). Results The mean pre-operative Merle d'Aubigné-Postel functional score was 4.7 and 9.8 at the time of last followup. There was one revision due to instability of the acetabular component. A cage system-Delta Revision TT-was successfully used in this case. Three cases with Paprosky type 3B defect showed cranial migration of the acetabular component by 6 mm, but stabilised after six months. No dislocations associated with acetabular surgery have occurred in the cohort. There have been no dissociations of the modular component. A fatigue fracture of the hemispherical module occurred in the revised case. No other hardware mechanical failures have been recorded. Conclusions TT cups, hemispherical modules and augments facilitate reliable and reproducible biological fixation in acetabular revision surgery with excellent results. Extended follow-up is necessary to evaluate the long-term performance of TT modular implants.

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Section: Discussionmentioning

confidence: 99%

Acetabular revision arthroplasty using trabecular titanium implants

Šteňo

Kokavec

Nečas

2014

International Orthopaedics (SICOT)

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“…CT vyšetření má výrazně vyšší senzitivitu. Vhodným nastavením přístroje jsou minimalizovány artefakty v okolí kovových komponent (27). Spolehlivě lze z jednotlivých řezů ve 2-3 rovinách prokázat osteolytická ložiska v okolí acetabula, dále pak odlišit vazivovou mezivrstvu od případných artefaktů v okolí implantátu (11).…”

Section: Tab 1 Hodnocení Výsledků Operace Podle Hodnoty Hhsunclassified

Mid-Term to Long-Term Results of Revision Total Hip Arthroplasty Using the Oval-Shaped Acetabular Cup - TC Type

Šťastný¹,

T²,

Frýdl³

et al. 2017

ACHOT

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INTRODUCTIONThe purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODSAltogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010. The mean follow-up was 8.2 years (5.1-11.6 years after the reimplantation, more than 10 years in 16 patients who underwent surgery). The position and osseointegration of the implant were assessed by digital radiography, the remodelling of transplanted bone tissues in the area of defects and between the implant ribs by computed tomography with reducing artefacts around the metal implant (Aquilion 64 -Toshiba Medical Systems), and for the clinical outcomes the Harris Hip Score was used. RESULTSPreoperatively, the condition of the hip joint based on the Harris Hip Score was in 30 cases evaluated as poor, in 8 patients as satisfactory. At the time of final evaluation, 8 patients achieved excellent results, in 19 patients the condition of the joint was very good (in 2 patients bilaterally), in 6 patients it was considered satisfactory and in 3 patients poor. The mean value for HHS increased from 39.5 to 84.5. Based on the radiography evaluation, in 27 patients (in 2 patients bilaterally) the osseointegration of the revision cup was good, in 8 cases with a radiolucent line of 2-4 mm in width in DeLee zone III, in one case proximal migration of the cup occurred caused by deep infection. The informed consent form for pelvic CT was signed by 25 patients of our cohort. Remodelling of bone tissue in the space between the ribs of the implant was always detected, the presence of bone cysts was not reported, the bone defects following the application of autologous spongioplasty in the monitored patients were healed. In 6 patients, an ingrowth of fibrous tissue of 2-4 mm in width in the convexity of the cup was detected. The mean survival of the revision oval-shaped cup -TC type with a follow-up of 8.2 years after the reimplantation based on Kaplan-Meier analysis was 91.4 %. DISCUSSIONThe number of revision total hip arthroplasties due to a younger age of patients who undergo alloplasty keeps growing. The choice of a revision implant should always match the intraoperative finding and the bone tissue quality. The standard uncemented implants with osteoactive surface can be opted for when anterior and posterior column of the acetabulum are intact (IIA and IIB according to Paprosky). Starting from type IIC, also the proximal part of acetabulum shall be considered. At our department, preference is given to the revision cup -TC type. The oval shape facilitates a lower degree of bone resection and easier restoration of the anatomical cent...

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Reconstruction of failed acetabular component in the presence of severe acetabular bone loss: a systematic review

et al. 2018

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Acetabular revision especially in the presence of severe bone loss is challenging. There is a paucity of literature critiquing contemporary techniques of revision acetabular reconstruction and their outcomes. The purpose of this study was to systematically review the literature and to report clinical outcomes and survival of contemporary acetabular revision arthroplasty techniques (tantalum metal shells, uncemented revision jumbo shells, reinforced cages and rings, oblong shells and custom-made triflange constructs). Full-text papers and those with an abstract in English published from January 2001 to January 2016 were identified through international databases. A total of 50 papers of level IV scientific evidence, comprising 2811 hips in total, fulfilled the inclusion criteria and were included. Overall, patients had improved outcomes irrespective of the technique of reconstruction as documented by postoperative hip scores. Our pooled analysis suggests that oblong cups components had a lower failure rate compared with other different materials considered in this review. Custom-made triflange cups had one of highest failure rates. However, this may reflect the complexity of revisions and severity of bone loss. The most common postoperative complication reported in all groups was dislocation. This review confirms successful acetabular reconstructions using diverse techniques depending on the type of bone loss and highlights key features and outcomes of different techniques. In particular, oblong cups and tantalum shells have successful survivorship.

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Mid-term results of revision total hip arthroplasty using the oval-shaped uncemented Trč-Cingr cup

Cited by 8 publications

References 17 publications

Acetabular revision arthroplasty using trabecular titanium implants

Acetabular revision arthroplasty using trabecular titanium implants

Mid-Term to Long-Term Results of Revision Total Hip Arthroplasty Using the Oval-Shaped Acetabular Cup - TC Type

Reconstruction of failed acetabular component in the presence of severe acetabular bone loss: a systematic review

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