Type III Acetabular Defect Revision With Bilobed Components

Moskal, Joseph T.; Higgins, Michael E.; Shen, Joseph

doi:10.1007/s11999-007-0079-1

Cited by 23 publications

(9 citation statements)

References 30 publications

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“…Comba et al [23] report the similar revision rate of 4.5 % in a series of 142 patients over a period of 4 years with an overall survival rate of 95.8 % (95 % CI 92.3-99.1). The use of cementless ''jumbo'', ''bilobed'' and ''oblong'' cups has shown similar or less favourable results compared to this series [24][25][26][27][28], but by virtue of the technique the restoration of bone stock is less necessary with these methods. Trabecular metal cups which are made from tantalum, offer the promise of improved primary stability as it provides excellent initial scratch fit.…”

Section: Discussionmentioning

confidence: 98%

Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study

Arumugam

Nanjayan

Quah

et al. 2015

Eur J Orthop Surg Traumatol

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Acetabular bone deficiency is one of the many challenging problems encountered in revision hip arthroplasty. A variety of surgical options and techniques are available including impaction bone grafting. We present our long-term experience of 68 consecutive cups in 64 patients, using impacted cancellous bone grafting with bone cement. With a mean follow-up of 10.5 year (IQR 7.5-12.9) after revision surgery, three implants had undergone further revision. Three patients had subsequent femoral peri-prosthetic fractures, and none of these three required further acetabular revision. Survival of the acetabular components was 95.5 % for all causes and 100 % for aseptic loosening as the end point, with a further four patients showing radiographic, but asymptomatic loosening. A significant correlation was found between previous revision and re-revision (early failure) (p = 0.01) as well as progression of lytic lesion and re-revision (p = 0.01). The median Harris hip score at final follow-up was 79.5 (IQR 67.9-80.4). The use of impacted morcellised allograft bone with a cemented cup is an effective technique to achieve longevity and restoration of bone stock in acetabular revision arthroplasty. Our series has shown good clinical and radiological outcome with survivorship of the prosthesis exceeding 95 % at 10 years.

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Section: Discussionmentioning

confidence: 98%

Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study

Arumugam

Nanjayan

Quah

et al. 2015

Eur J Orthop Surg Traumatol

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“…As far as we know, there are no articles regarding outcome with BOFOR cups. Other types of implants—such as the bilobed cups used in hip revision surgery—provide different results, although the number of cases is not very large [1, 5, 29]. Although bilobed acetabular revision components are different, they also try to fill overlying defects and relocate the hip rotation center.…”

Section: Discussionmentioning

confidence: 99%

“…Abeyta et al reported the long-term results of 15 hips using S-ROM (DePuy Johnson & Johnson, Leeds, UK) oblong bihemispherical cups; three cups were revised due to aseptic loosening, and one showed complete radiolucency around the cup [1]. On the other hand, Moskal et al [29] assessed 11 bilobed components in combined acetabular defects that did not require revision over a five-year follow-up. Although most of series have shown good results for oblong or bilobed cups, Babis et al [2] recently observed poor results for the PROCOTYL E cup (Wright Medical Technology, Arlington, TN, USA) in Paprosky defect type 3A, and they do not recommend this technique (Table 6).…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty

García-Rey

Fernández-Fernández

Durán

et al. 2012

J Orthopaed Traumatol

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BackgroundThe preoperative bone defect and the reconstruction of the center of rotation of the hip are critical in acetabular revision surgery. Uncemented oblong cups are employed in order to manage these issues. We analyzed the clinical results and rates of revision of two different uncemented oblong cups, the reconstruction of the center of rotation of the hip, as well as the rate of radiological loosening and possible risk factors.Materials and methodsForty-five patients (46 hips) underwent acetabular revision surgery using two different uncemented oblong cups. We assessed the clinical results and the survival rate for revision and aseptic loosening. Intraoperative bone loss was classified according to Paprosky, and acetabular reconstruction was assessed according to Ranawat. The mean follow-up was 7.2 years (range 4–11 years).ResultsThere were four re-revisions (three due to aseptic loosening); the survival rate for re-revision due to aseptic loosening was 60.1 % at seven years. The mean distance between the center of the femoral head prosthesis and the approximate center of the femoral head improved from 21.5 to 10.2 mm. Thirteen cups showed radiological loosening; the survival rate for radiological loosening at seven years was 40.54 %. A smaller postoperative horizontal distance was correlated with cup loosening.ConclusionsAlthough optimal acetabular reconstruction can be achieved by using oblong uncemented cups in revision hip surgery, the clinical and radiological results are not encouraging. Excessive medialization of the cup may increase the rate of loosening.

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“…Bei 21 Patienten lag ein zweitgradiger Defekt des Azetabulums nach D'Antonio vor. 23 Patienten wiesen einen Defektgrad III auf. Eine Beckendiskontinuität (D'Antonio IV) lag bei sechs Patienten zugrunde.…”

Section: Weiterbehandlungunclassified

“…Um noch eine hemisphärische Pfanne implantieren zu können, müsste groß aufgefräst werden, was zu einem weiteren Knochenverlust führen würde. Durch die Verwendung von längsovalen oder kranial aufgesockelten Systemen kann eine Defektdeckung jedoch auch ohne vollständig tragfähige ossäre Pfannenzirkumferenz erreicht werden [13,19,23]. Bei kombinierten Defekten sollte dabei ein Implantat mit äußerer Abstützmöglichkeit verwendet werden, um eine Primärstabilität zu gewährleisten [40].…”

Section: Standardized Reconstruction Of Acetabular Bone Defects Usingunclassified

Das Kranialpfannensystem zur defekttypassoziierten Therapie von Azetabulumdefekten

et al. 2010

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A total of 50 cup revisions using the ESKA cranial socket system were clinically and radiologically analyzed with an average follow-up of 65.7+/-28.5 months (26-123 months). Defects were classified according to D'Antonio. There were 21 type II, 23 type III, and six type IV defects. The Harris Hip Score increased from 40 preoperatively to 68.3 points postoperatively. Four patients had recurrent hip dislocation requiring replacement of the inlay. In four cases of aseptic loosening, the acetabular component had to be revised. With revision of the acetabular component as an endpoint, implant survival was 92% after an average of 5.4 years.

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Type III Acetabular Defect Revision With Bilobed Components

Cited by 23 publications

References 30 publications

Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study

Revision hip arthroplasty using impacted cancellous bone and cement: a long-term follow-up study

Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty

Das Kranialpfannensystem zur defekttypassoziierten Therapie von Azetabulumdefekten

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