BACKGROUND: Isolated revision of an acetabular total hip component is associated with special problems related to the retention of the femoral component. We reviewed the intermediate-term results of a series of such operations with use of the Harris-Galante Porous acetabular component. METHODS: We retrospectively studied the results of ninety-five isolated acetabular revisions, specifically focusing on sixty-three that had been followed for a minimum of sixty months (average, 130 months). Evaluation measures included the Harris hip score, radiographic analysis, complications, and prosthetic survival. Follow-up information was obtained with self-administered questionnaires, telephone contact, and/or clinical examination. The effects of a femoral component with a modular neck-head junction and of trochanteric osteotomy on the dislocation rate were evaluated. RESULTS: Nine shells were rerevised: four because of recurrent dislocation, four because of aseptic loosening, and one because of dissociation of the liner. The survival rate with rerevision of the shell as the end point was 90.5% at 120 months. Pelvic osteolysis occurred in 4% of the cases. The dislocation rate for the sixty-three hips was 8%. When femoral component modularity was accounted for, the analysis of the dislocations revealed a significantly higher dislocation rate for the hips without a trochanteric osteotomy (p = 0.04). Eight arthroplasties were complicated by nerve palsies, seven of which resolved fully or nearly so. CONCLUSIONS: Isolated acetabular revision with use of the Harris-Galante Porous acetabular component was associated with a low rate of loosening, lysis, and rerevision of the shell at the time of intermediate-term follow-up. However, there was a high rate of complications, including trochanteric nonunion, dislocation, and nerve palsy. The performance of a trochanteric osteotomy was associated with a decreased rate of dislocation.
BACKGROUND: Isolated revision of an acetabular total hip component is associated with special problems related to the retention of the femoral component. We reviewed the intermediate-term results of a series of such operations with use of the Harris-Galante Porous acetabular component. METHODS: We retrospectively studied the results of ninety-five isolated acetabular revisions, specifically focusing on sixty-three that had been followed for a minimum of sixty months (average, 130 months). Evaluation measures included the Harris hip score, radiographic analysis, complications, and prosthetic survival. Follow-up information was obtained with self-administered questionnaires, telephone contact, and/or clinical examination. The effects of a femoral component with a modular neck-head junction and of trochanteric osteotomy on the dislocation rate were evaluated. RESULTS: Nine shells were rerevised: four because of recurrent dislocation, four because of aseptic loosening, and one because of dissociation of the liner. The survival rate with rerevision of the shell as the end point was 90.5% at 120 months. Pelvic osteolysis occurred in 4% of the cases. The dislocation rate for the sixty-three hips was 8%. When femoral component modularity was accounted for, the analysis of the dislocations revealed a significantly higher dislocation rate for the hips without a trochanteric osteotomy (p = 0.04). Eight arthroplasties were complicated by nerve palsies, seven of which resolved fully or nearly so. CONCLUSIONS: Isolated acetabular revision with use of the Harris-Galante Porous acetabular component was associated with a low rate of loosening, lysis, and rerevision of the shell at the time of intermediate-term follow-up. However, there was a high rate of complications, including trochanteric nonunion, dislocation, and nerve palsy. The performance of a trochanteric osteotomy was associated with a decreased rate of dislocation.
Authors: Colin T Penrose; Thorsten M Seyler; Samuel S Wellman; Michael P Bolognesi; Paul F Lachiewicz Journal: Clin Orthop Relat Res Date: 2016-10 Impact factor: 4.176