The Double-Cup Construct: A Novel Treatment Strategy for the Management of Paprosky IIIA and IIIB Acetabular Defects

Webb, Jonathan E.; McGill, Robert J.; Palumbo, Brian T.; Moschetti, Wayne E.

doi:10.1016/j.arth.2017.04.017

Cited by 22 publications

(35 citation statements)

References 19 publications

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“…Clinical and radiographic data ( Fig.1) about enrolled patients were collected under the same criteria. Aseptic loosening was diagnosed by the uniform standard of clinical and radiological, including existence of radiolucent lines, migration of implant, or disruption of screw [3]. Musculoskeletal Infection Society (MSIS) was used to diagnose periprosthetic joint infection [12], and these patients were all managed with two-stage revision strategy.…”

Section: Patientsmentioning

confidence: 99%

“…The criteria about osseointegration [4] and the Oswestry classification [2] were separately applied to evaluate ingrowth of uncemented component and the integration of allograft, and any heterotopic ossifications were noted and evaluated based on the system of Brooker et al [20]. We recorded and calculated the change of the hip center of rotation through measuring preoperative and the latest follow-up radiographs [3]. We measured the acetabular cup inclinations directly [21] and calculated the acetabular cup antevesion using the method suggested by Pradhan [22] on anteroposterior radiographs.…”

Section: Clinical and Radiological Assessmentsmentioning

confidence: 99%

“…Multiple treatment options and various special implants for the reconstruction of acetabular defects have been developed [1,3]. However, acetabular revision for severe bone defects is still a challenging surgery because of the high incidence of complications [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…However, acetabular revision for severe bone defects is still a challenging surgery because of the high incidence of complications [4,5]. The main complication is dislocation after revision hip arthroplasty [3], and it is more common in revision hip arthroplasty than primary THA [1]. Restoration of the native hip center of rotation (COR) is crucial in primary THA and revision hip arthroplasty [6].…”

Section: Introductionmentioning

confidence: 99%

“…However, poor results in revision hip arthroplasty using structural bone grafts without reinforcement devices have been reported [5]. Recently, some studies consider the technique of using custom-made implants in combination with trabecular metal prosthetic component was a reliable option to deal with severe acetabular defects [3,10]. However, to increase the function results, new strategy of using impacting bone grafting and other revision devices was recommended [11].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Reconstruction of Paprosky III defects with double-trabecular metal cups in acetabular revision at five-year follow-up

Zhang

Wan

Wang

et al. 2020

Preprint

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Background: Acetabular revision is often difficult to manage because of severe bone loss, especially for Paprosky type Ⅲ defects. Our present study aimed to assess the strategy of double-trabecular metal cups in acetabular revision.Methods: Fifteen patients (15 hips) underwent acetabular revision using double-cup technique alone or in combination with impacting bone grafting between January 2008 and May 2015. Preoperative and the latest follow-up clinical and radiographic scores were recorded and compared. Results:No patients were lost to follow up, and no patients underwent re-revision for loosening or any other reasons at the mean follow-up duration of 66 (range 55-105) months. We discovered 3 patients (3/15) with the early dislocation within the first year after the surgery and 2 patients (2/15) with delayed wound healing. The comparison between preoperative and the latest follow-up results showed the records of modified Harris Hip Score, University of California, Los Angeles activity score, Short Form 36, limb-length discrepancy and hip center of rotation were significantly improved. Conclusions:The application of double-cup technique alone or in combination with impacting bone grafting is an effective and reliable treatment option for Paprosky type Ⅲ acetabular defects without pelvic discontinuity.

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Section: Patientsmentioning

confidence: 99%

Section: Clinical and Radiological Assessmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reconstruction of Paprosky III defects with double-trabecular metal cups in acetabular revision at five-year follow-up

Zhang

Wan

Wang

et al. 2020

Preprint

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Clinical study of outcomes after revision surgery using porous titanium custom-made implants for severe acetabular septic bone defects

Burastero

Cavagnaro

Chiarlone

et al. 2020

International Orthopaedics (SICOT)

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Purpose Acetabular bone loss is a challenging problem in revision total hip arthroplasty (rTHA). Severe bone loss is not uncommon especially in periprosthetic joint infection. Surgical options, including revision shells, rings, and cages-with or without bone allograft-are affected by high complication rates and unsatisfactory clinical results. We report our mid-term results of non-flanged, custom-made acetabular components in staged rTHA. Methods We retrospectively reviewed all patients undergoing two-stage revision with acetabular custom-made implants between 2014 and 2016 at a single institution. Harris Hip Scores, Oxford Hip Scores, and Visual Analogue Scales for pain were obtained, and radiographical follow-up was performed. Complications were reported and analysed. Results We included 19 patients (19 hips) with an average follow-up of 42.3 ± 11.8 months. At the time of re-implantation, significant acetabular bone loss according to Paprosky classification (IIC, IIIA-B, and pelvic discontinuity) was detected in our patients. Clinical outcomes showed statistically significant improvement from pre-operative visit to last follow-up (p < 0.01). All custom-made implants had radiological osseointegration, and we did not find any implant complications, such as loosening or malposition. No mismatch between pre-operative planning and intra-operative findings was observed. To date, we report one septic failure managed with second staged revision, and one re-operation for recurrent THA dislocation. Conclusions Custom-made acetabular implants showed excellent clinical and radiographic mid-term outcomes with a low rate of related complications, providing implant stability on residual host bone, restoring hip biomechanics, and allowing biological osseointegration. Further long-term studies are needed to confirm preliminary results.

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Modular revision strategy with bispherical augments in severe acetabular deficiency reconstruction

Zhang

Chen

et al. 2021

International Orthopaedics (SICOT)

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The Double-Cup Construct: A Novel Treatment Strategy for the Management of Paprosky IIIA and IIIB Acetabular Defects

Cited by 22 publications

References 19 publications

Reconstruction of Paprosky III defects with double-trabecular metal cups in acetabular revision at five-year follow-up

Reconstruction of Paprosky III defects with double-trabecular metal cups in acetabular revision at five-year follow-up

Clinical study of outcomes after revision surgery using porous titanium custom-made implants for severe acetabular septic bone defects

Modular revision strategy with bispherical augments in severe acetabular deficiency reconstruction

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