Surgical Treatment of Isolated Aseptic Acetabular Loosening in Patients With Stable Femoral Component

Abstract

Background: Aseptic acetabular loosening currently occupies the 1st place in the structure of delayed complications after total hip arthroplasty. The basis of treatment is the replacement of a loosening cup and a pair of friction. The tactics of surgical treatment of the stable correctly oriented femoral component have not been determined, thoroughly which confirms the relevance of the study.Aims: Compare the effectiveness of total hip revision and isolated acetabular revision in patients with aseptic acetabular loosening and stable correctly oriented femoral component.Materials and methods: The study presented the results of surgical treatment performed in 44 patients (45 revisions) with isolated aseptic acetabular loosening and stable correctly oriented femoral component were presented, Patients were divided into two groups depending on the severity of surgery. The first group included 16 patients with a total revision due to irregular cone of the stem. The second group included 28 patients (29 revisions) with an isolated replacement of the unstable cup and a pair of friction.Results: In the 1st group, revision surgery was performed to replace both cup with the friction pair and stable correctly oriented stem which finally results in lower postoperative red blood counts (erythrocytes, hemoglobin, hematocrit), as well as higher intraoperative blood loss volume and longer duration of surgical intervention if compare to the 2nd group where the stable correctly oriented femoral component was not changed. Postoperative results assessed using Harris scales and Oxford Hip Score in the comparison group were at a higher level during the whole period of follow-up. A moderate coorelation between the severity of the revision intervention and its results was detected.Conclusions: Preservation of a stable correctly oriented stem allows to reduce the severity of the revision intervention which improves the results and shortens the period of patient rehabilitation.