Abstract
Introduction
In most cases of revision acetabular total hip arthoplasty (THA), some degree of bone loss will be accompanied. If the bone loss is massive, the management of bone defect is more challenging problem. We consider that using cementless accetabular cup for revision acetabular reconstruction is good indication when stable interface fit between the acetabular cup and bone is achieved. The purpose of this study is to review the result of revision hip arthroplasty using cementless acetabular cup with and without bone graft.
Materials and methods
Between 1998 and 2012, 65 revisions using cementless acetabular cup (Mallory-Head 4 Finned component) were performed in 64 patients, whose mean age was 64.9 years. The cases of revision are aseptic loosening (53 joints), and infection (12 joints). All patients were followed up for a minimum period of 24.0 months (mean, 84 months) and were divided into two groups as follows: in group A, revisions without bone graft (28 joints); in group B, revisions with bone graft (37 joints). We compared clinical and radiographical results of group A with group B.
Results
According to Paproski's classification, bone defects in Group A were evaluated as either Type I or Type IIa, and those in Group B were in the range of Type IIb to Type IIIb. Large cementless accetablar compornent with diameters of 58 mm or more were used in 6 joints and 21 cases, respectively. Postoperative radiography showed there were no significant deference of the position of hip center, lateral inclination and anteversion of acetabular cup in each group. The migration of the socket in the superior and medialaxes has not been observed in all cases at the latest follow-up. The mean JOA hip score improved from 63.1 points to 88.3 points and from 53.2 to 86.1, respectively and there were no cases of re-revisions in this series.
Conclusions
Depending on the bone defect, large cementless accetablar compornent and bone graft should be considered. We are confident that results of acetabular reconstraction using cementless acetabular cup are satisfactory.
