BACKGROUND: Revision of failed total hip arthroplasty (THA) presents great challenge to any orthopaedic surgeon especially in the presence of acetabular defects where the main goal is to achieve durable fixation of prosthetic components to bone which is the key to successful revision surgery. METHODS: Seventeen patients (17 hips) with mean age of 52 (40-61) years had revision surgery for aseptic failure of Furlong hydroxyapatite-ceramic-coated (HAC) prosthesis using cementless jumbo cups. Patients were reviewed clinically and radiographically with mean follow-up of 3.5 years (2-6). No patient was lost to follow up. RESULTS: All revised acetabular components showed polyethylene wear, severe metallosis, with acetabular defects IIB (4/17), and IIIA (13/17) according to Paprosky classification. The femoral component was well fixed in all cases but one patient had stem revision for femoral fracture mal-union. There was one early post-operative infection; there was no postoperative dislocation, sciatic nerve injury, periprosthetic fracture or deep venous thrombosis. At last follow-up, no progressive radiolucencies or acetabular migration was identified. The mean Harris hip score improved from 42 (24-59) pre-operatively to 85 (72-92). CONCLUSION: Good clinical results and radiographic stability were obtained at short term follow up after acetabular revision using cementless jumbo cups, which justify its use in revision surgery even in the face of major acetabular defects. Furlong HAC femoral component gives excellent long-term survival in young and active patients with a survival rate of 94% at 18.6 years.
BACKGROUND: Revision of failed total hip arthroplasty (THA) presents great challenge to any orthopaedic surgeon especially in the presence of acetabular defects where the main goal is to achieve durable fixation of prosthetic components to bone which is the key to successful revision surgery. METHODS: Seventeen patients (17 hips) with mean age of 52 (40-61) years had revision surgery for aseptic failure of Furlong hydroxyapatite-ceramic-coated (HAC) prosthesis using cementless jumbo cups. Patients were reviewed clinically and radiographically with mean follow-up of 3.5 years (2-6). No patient was lost to follow up. RESULTS: All revised acetabular components showed polyethylene wear, severe metallosis, with acetabular defects IIB (4/17), and IIIA (13/17) according to Paprosky classification. The femoral component was well fixed in all cases but one patient had stem revision for femoral fracture mal-union. There was one early post-operative infection; there was no postoperative dislocation, sciatic nerve injury, periprosthetic fracture or deep venous thrombosis. At last follow-up, no progressive radiolucencies or acetabular migration was identified. The mean Harris hip score improved from 42 (24-59) pre-operatively to 85 (72-92). CONCLUSION: Good clinical results and radiographic stability were obtained at short term follow up after acetabular revision using cementless jumbo cups, which justify its use in revision surgery even in the face of major acetabular defects. Furlong HAC femoral component gives excellent long-term survival in young and active patients with a survival rate of 94% at 18.6 years.
Authors: N Sandiford; C Doctor; S S Rajaratnam; S Ahmed; D J East; K Miles; A Butler-Manuel; J A N Shepperd Journal: Bone Joint J Date: 2013-04 Impact factor: 5.082
Authors: Gunnar B Flugsrud; Lars Nordsletten; Birgitte Espehaug; Leif I Havelin; Haakon E Meyer Journal: Acta Orthop Date: 2007-02 Impact factor: 3.717