Abstract
Aim: to evaluate the use of large acetabular cup in revision surgery without structural bone graft.
Materials/methods: Patients who had revision hip surgery at Greenwich Hospital between 1991 and 1994 were reviewed. All patients had complete clinical and radiological follow up.
Large cup was the press fit Mathys Isoelastic cup.
No patient had any structural bone grafting.
Failure was defined as need for surgery and/or poor clinical outcome.
Objective clinical assessment was done using the Harris Hip score.
Radiological assessment was carried out using RC Johnston’s criteria for uncemented cups.
Results: 52 revised cups in 48 patients were reviewed. Mean age was 71.6yrs, 21 males and 27 females. Mean follow up was 6 years (4 to 8 years). Average cup size was 64 mm (62 to 66).
Diagnosis at index operation was 10 Rheumatoid, and 42 osteoarthrosis. Average Harris Hip Score was 85 (excellent 35, good 11, fair 3, poor 3)
Radiological assessment showed excellent bony incorporation in all but the failures. There were 3 failures, 1 due to infection (revision was for infected primary THR), and 2 due to aseptic loosening in rheumatoid patients (both had significant cup malposition at revision). The major complications included 2 intraoperative fractures.
Conclusion: Intermediate term results of acetabular revisions, using large cups, without structural bone grafting, in our hands, are encouraging. Cup position at revision appears crucial for long-term survival.
The abstracts were prepared by Peter Kay. Correspondence should be addressed to him at Centre for Hip Surgery, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP.
