Between July 2000 and December 2002, 263 consecutive patients across 5 surgical centers underwent to a revision surgery of a failed acetabular component in which TM acetabular components were used. There were 150 women and 113 men with a mean age of 69.5 years. The indication for acetabular revision was aseptic loosening in 186 cases (70.7%). Clinical evaluations were performed using the Harris hip score, the WOMAC and UCLA activity scale. Implant and screw position, polyethylene wear, radiolucent lines, gaps, and osteolysis were assessed. Preoperatively, acetabular bone deficiency was categorized using the classification of Paprosky et al. Statistical analysis was performed using nonparametric correlations. Standard life table was constructed, and the survival rate was calculated by means of Kaplan-Meier method. The overall mean follow-up was 73.6 months (range, 60–84 months), and no patient was lost to follow-up. The preoperative HHS rating improved from a mean of 43.6 ± 11.4 before revision, to a mean of 82.1 ± 10.7. None of the patients was re-revised for loosening. The cumulative prosthesis survival was 99.2% at 5 years. There was no correlation found between the various degrees of acetabular bony defect and the magnitude of clinical results (independent of pre-revision Paprosky grade). The use of component augments allowed us to minimize the volume of morsellized allograft used for defect repair. TM acetabular component demonstrates promising midterm results similar to those reported by other authors

Introduction. Acetabular bone deficiency presents one of the most challenging problems during revision hip arthroplasty. A variety of surgical options and techniques are available including impaction bone grafting. We present our medium to long-term experience of 68 consecutive hips in 64 patients who had acetabular revision using impacted cancellous bone grafting with bone cement with a mean follow up of 10.5 ±3.75) years (range 5.1 to 17.7 years). Methods. Patients' undergoing acetabular bone grafting during revision hip arthroplasty prior to insertion of a cemented cup between 1993 and 2000 were evaluated. Pre-operative, immediate post-operative, 1 year post-op and final follow-up radiographs were evaluated. The pre-operative bone loss was graded according to the AAOS and Paprosky classifications. The presence of radiolucencies, alignment and incorporation of bone graft were evaluated. The Harris Hip Score (HHS) was used to assess clinical outcome. 13 patients who were unable to attend the department were contacted for a telephone interview. Analysis of the Data was carried out using SPSS17 [SPSS Inc. Chicago, Illinois]. Results. 64 consecutive patients (68 hips) were evaluated with an average age of 69.9 (± 10.24) years. At the mean follow up of 10.5 years [5.1–17.7 years] Kaplan-Meier survivorship analysis predicted a rate of survival of the acetabular component of 95.5% (95% confidence interval (CI) 92 to 99) at 10 years, with revision for any reason as the endpoint. The median Harris hip score at final follow up was 79.5 [IQR 67.9–80.45]. Neither the extent of initial defect or acetabular inclination were related to clinical outcome or predicted further revision. Progression of the radiololucent zones between the cement bone interface was a predictor of loosening and further revision. Discussion. Our findings have shown that acetabular revision using impacted cancellous bone graft and a cemented acetabular component remains a reliable and successful technique for patients with poor femoral bone stock