O2371 FATE OF CEMENTLESS ACETABULAR COMPONENTS RETAINED DURING REVISION OF A FEMORAL COMPONENT OF A TOTAL HIP ARTHROPLASTY

Abstract

Aims: The purpose of this study was to determine the success of retaining a well-þxed acetabular component at the time of isolated femoral revision and identify variables that may inßuence clinical decision making and outcome. Methods: 83 consecutive patients (90 hips) with a retained cementless socket during revision of a femoral component were reviewed. Eighty-þve percent of the hips were initially reconstructed as metal on polyethylene surface arthroplasty (SA) and 15% as a standard stem type total hip replacement (THR). Average age at the time of revision was 54. 33% of the patients had acetabular osteolysis of which 52% were grafted. Results: Mean follow up 9.6 years (5.5 to 15.9). Average time in situ of socket 14.8 years (7.1 to 20.2). 5 sockets were revised at a mean of 6.8 (2.5–10.4) years post revision and 13.1 years in situ. Reasons for socket revision were: 1 socket loosening, 1 dissociation of the liner cemented into the original socket, 1 instability, 1 conversion to a Metal/Metal bearing and 1 because it was the surgeonñs preference to remove the well-þxed socket. Dislocation rate was 15% with 50% occurring in the þrst 6 months post revision. Nine had more than one episode of dislocation. No recurrence or expansion of pelvic osteolysis was observed at last follow-up. Discussion: Revision of a cementless socket on the basis of the duration in vivo and/or presence of osteolysis does not appear to be warranted. Because of the high risk of dislocation off set liners/stems and larger femoral head sizes should be considered, especially in revision of SA.