Abstract
Introduction: The objective of the study was to test the hypothesis that revision total hip arthoplasty in cases with extensive acetabular bone defects performed with a newly developed, conical, titanium, ribbed shaft socket designed for cementless press-fit into the dorsocranial ilium would not demonstrate inferior outcomes using literature controls.
Methods: 38 consecutive hips had an acetabular revision with a pedestal cup. All of the patients had a type IIIa or IIIb defect according the Paprosky-classification. There was an average follow-up of 4.2 years, with a range of 3 to 6 years. Two patients died, one patient was lost to follow-up. All patients were evaluated radiographically, by CT-Scan and clinically.
Results: At the time of follow-up, 32 (91.4%) cups were stable. Aseptic loosenings occured in one case, septic loosenings occured in 2 cases. The average Harris Hip Score improved from 43 points (range: 16–78 points) preoperatively to 82 points (range 56–98 points) postoperatively. Complications included four dislocations without recurrency. The guide instrument facilitates correct anchorage in the dorsal ilium in all cases.
Conclusion: The presented findings show the short-term efficancy of the procedure with respect to implant fixation and clinical results in large acetabular defects, but longer follow-ups and a larger number of patients are needed before the durability of this reconstructive technique can be assessed. The implant allows restoration of the correct centre of rotation, equalization of leg length and optimization of the strength of the hip abductors. Our results should be considered encouraging.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
