Results of trabecular metal augments in Paprosky IIIA and IIIB defects

Eachempati, Krishna Kiran; Malhotra, Rajesh; Pichai, Saravanan; Reddy, A V Gurava; Subramani, A K Podhili; Gautam, Deepak; Bollavaram, V R; Sheth, Neil P.

doi:10.1302/0301-620x.100b7.bjj-2017-1604.r1

Cited by 34 publications

(26 citation statements)

References 37 publications

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“…The mean acetabular component diameter was between 54 mm (range: 44-70 mm) 23 and 64 mm (range: 50-70 mm). 28 Six studies 17,18,20,23,27,28 reported information regarding the femoral head size, ranging from 28 to 40 mm; largest femoral head was preferred to minimize the risk of instability. All authors reported cases where highly cross-linked polyethylene liners were used, standard or with an elevated rim.…”

Section: Acetabular Componentsmentioning

confidence: 99%

“…Thirteen studies (87%) [18][19][20][21][22][23][24][25][26][27][28]30,31 noted that they used multiple screws to stabilize both the acetabular cup and the augment, whereas two studies (13%) 17,29 did not report if screws were used. Ten studies (67%) [18][19][20][21]23,24,26,28,30,31 also specified the number of screws used for the stabilization of either the acetabular component or the metal augment. Clinical or radiological outcomes were not significantly correlated with the number of screws utilized (►Table 3).…”

Section: Acetabular Componentsmentioning

confidence: 99%

“…Fourteen studies [17][18][19][20][21][22][23][24][25][27][28][29][30][31] accounting for 806/849 (95%) cases included in this systematic review used the Paprosky classification 3 to grade acetabular defects before surgery, which were then confirmed intraoperatively. Acetabular bone loss grading was 2A in 58 cases (7.2%), 2B in 139 cases (17.2%), 2C in 72 (8.9%), 3A in 360 (44.7%), and 3B in 177 (22.0%) cases.…”

Section: Classification Of Acetabular Defects Requiring Trabecular Metal Augmentsmentioning

confidence: 99%

“…All mean clinical/functional subjective scores used in the studies of this review demonstrated significant postoperative improvement compared with preoperative mean values. The Harris Hip Score was used in nine articles (60%), 17,18,21,23,25,[27][28][29]31 while the Oxford Hip Score was used in two studies (13%). 26,30 The Western Ontario and…”

Section: Clinical/functional Outcomesmentioning

confidence: 99%

“…1). [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Twelve out of them (80%) [18][19][20][21][22][23][24][26][27][28][29]31 were retrospective case series, two (13%) were prospective case series, 25,30 and one (7%) was a retrospective case-control study. 17 One study (6.7%) was classified as level of evidence III 17 and 14 studies (93%) as level of evidence IV.…”

Section: Study Selectionmentioning

confidence: 99%

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Trabecular Metal Augments for Treatment of Acetabular Defects: A Systematic Review

Malahias

Mancino

et al. 2021

The Journal of Hip Surgery

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Severe acetabular bone defects during revision total hip arthroplasty are often treated with a hemispherical shell and highly porous modular metal augments. Several papers have been already published reporting on the clinical performance of trabecular metal (TM) augments combined with a hemispherical shell for the management of severe acetabular defects. However, no systematic review of the literature has been published to date. The U.S. National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications utilizing keywords pertinent to tantalum augments and TM (Zimmer Biomet, Warsaw, Indiana) augments, revision THA, clinical outcomes, and complications associated with these procedures. Fifteen articles were found to be suitable for inclusion in the present study, which included 769 revision cases where acetabular augments were used. The majority of acetabular bone defects were type 3 according to the Paprosky classification (type 2A in 58 cases, 7.2%; type 2B in 139 cases, 17.2%; type 2C in 72 cases, 8.9%; type 3A in 360 cases, 44.7%; and type 3B in 177 cases, 22.0%). The overall revision rate for the 769 acetabular revisions with augments was 5.7% (46 cases) at mean mid-term follow-up. The most common reasons for revision were dislocation (3.3%), periprosthetic joint infection (2.9%), and aseptic loosening (2.7%). TM augments combined with hemispherical shells were found to be effective in the treatment of moderate-to-severe acetabular bone defects with a 5% acetabular component revision rate at mean mid-term follow-up. The literature did not delineate whether pelvic discontinuity was associated with a higher risk of aseptic loosening after TM augment. Further studies are needed to clarify the impact of additional screw fixation on survival rates, and whether the type of augment (wedge augments, “flying buttress” augments, column augments), the configuration used, and the number of screws influence clinical and radiographic outcomes.

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