Abstract
Aims: The purpose of this study is to evaluate clinic and radiological results in acetabular revision using hemispherical hydroxyapatite (HA)-coated cups and morselized allograft in the presence of sever bone defects (Paprosky type IIIA). Methods: From a serie of 218 patients having revision total hip arthroplasty between1995 and 1999, 42 hips in 42 patients were included in this retrospective study. The inclusion criteria were:
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Ð Presence of sever bone loss without pelvic discontinuity (Paprosky type IIIA).
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Ð Use of hemispherical HA-coated acetabular component inserted without cement.
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Ð Aseptic loosening as cause of revision.
All revisions were carried out by the same surgical team using a posterolateral approach. Morselized allograft was used in all cases. The mean age at the time of revision surgery was 70 years (range, 48 to 84). The mean follow-up was 52 months (range, 36 to 81). In 39% of the cases a extra large cup (more than 60 mm) was used. Results: the average Merle dñAubignŽ score rose from 7.3 points preoperatively to 17.2 points at follow-up (90% of the patients were pain free). All the cups remained radiologically stable at follow-up. Partial resorption of the allograft without jeopardising implant stability was detected in 4 cases (10%); all the rest showed radiological consolidation and remodelling of the medial wall of the acetabulum. Conclusions: these results strongly support the use of hemispherical HA-coated cups, combined with morselized allograft, in acetabular revision even in the presence of major acetabulum bone loss.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
