Loris Perticarini1, Stefano Marco Paolo Rossi2, Marta Medetti3, Francesco Benazzo1,4. 1. Sezione Di Chirurgia Protesica Ad Indirizzo Robotico - Unità Di Traumatologia Dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy. 2. Sezione Di Chirurgia Protesica Ad Indirizzo Robotico - Unità Di Traumatologia Dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy. rossi.smp@gmail.com. 3. Clinica Ortopedica e Traumatologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 4. Università Degli Studi Di Pavia, Pavia, Italy.
Abstract
BACKGROUND: This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. METHODS: Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29-90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. RESULTS: Average follow-up was 91 (range 24-146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25-70; SD 9) preoperatively to 84.4 (range 46-99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan-Meier survivorship was assessed to be 88.54% (95% CI 80.18-93.52%) at 71 months, with failure of the cup for any reason as the endpoint. CONCLUSION: Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. LEVEL OF EVIDENCE: Level IV prospective case series.
BACKGROUND: This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. METHODS: Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29-90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. RESULTS: Average follow-up was 91 (range 24-146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25-70; SD 9) preoperatively to 84.4 (range 46-99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan-Meier survivorship was assessed to be 88.54% (95% CI 80.18-93.52%) at 71 months, with failure of the cup for any reason as the endpoint. CONCLUSION: Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. LEVEL OF EVIDENCE: Level IV prospective case series.
Entities:
Keywords:
Acetabular bone loss; Acetabular reconstruction; Revision total hip arthroplasty; Trabecular titanium cup
Authors: Kevin J Bozic; Steven M Kurtz; Edmund Lau; Kevin Ong; Thomas P Vail; Daniel J Berry Journal: J Bone Joint Surg Am Date: 2009-01 Impact factor: 5.284
Authors: E Marin; M Pressacco; S Fusi; A Lanzutti; S Turchet; L Fedrizzi Journal: Mater Sci Eng C Mater Biol Appl Date: 2013-02-24 Impact factor: 7.328
Authors: Anne E Postler; Franziska Beyer; Tim Wegner; Jörg Lützner; Albrecht Hartmann; Ishaq Ojodu; Klaus-Peter Günther Journal: Hip Int Date: 2016-11-22 Impact factor: 2.135
Authors: Federico De Meo; Giorgio Cacciola; Vittorio Bellotti; Antongiolio Bruschetta; Pietro Cavaliere Journal: Hip Int Date: 2018-11 Impact factor: 2.135