Cup-on-cup technique: a reliable management solution for severe acetabular bone loss in revision total hip replacement
| Autor: | Giorgio Burastero, Lorenzo Mosconi, Francesco Chiarlone, Luca Cavagnaro, Andrea Zanirato, Mattia Alessio Mazzola, Lamberto Felli, Stefano Lovisolo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation Revision total hip replacement Arthroplasty Replacement Hip porous tantalum Dentistry Paprosky IIIA–IIIB Tantalum cup-on-cup technique Acetabular bone defects Fixation (surgical) Osseointegration Acetabular bone Humans Medicine Orthopedics and Sports Medicine Bone Resorption revision total hip arthroplasty Aged Retrospective Studies Aged 80 and over business.industry Porous tantalum Acetabulum Middle Aged Prosthesis Failure Radiography Female Surgery Hip Prosthesis Implant business Total hip arthroplasty |
| Zdroj: | HIP International. 30:12-18 |
| ISSN: | 1724-6067 1120-7000 |
| Popis: | Background: The management of acetabular bone loss is a challenging problem in revision total hip arthroplasty (rTHA). The goals of treatment are a stable acetabular fixation, implant stability, and restoration of hip centre of rotation. This study aims to report clinical, radiological outcomes and complications at short-term to mid-term follow-up of the cup-on-cup technique in the management of severe acetabular bone loss in rTHA. Methods: We retrospectively reviewed the records of patient receiving rTHA performed with double porous tantalum cup technique in a single Joint Replacement Unit from 2014 to 2017. Objective and subjective clinical scores (Harris Hip Score, Oxford Hip Score, and visual analogue scale), radiological parameters (centre of rotation, leg-length discrepancy, heterotopic ossification, osseointegration, loosening and radiolucencies) and complications were recorded. We analysed the implant survival rate and periprosthetic joint infection rate. Results: We included 9 patients (9 hips) with a mean follow-up of 35.3 ± 10.8 months. Functional scores showed a statistically significant improvement at the final follow-up ( p < 0.01). All patients rated their surgery as satisfactory. The cup-on-cup construct demonstrated radiological osseointegration with the centre of rotation restoration and leg length discrepancy improvement. In 1 patient, periprosthetic joint infection was diagnosed and treated with suppressive antibiotic therapy. No patients underwent acetabular components revision surgery for any reason. Conclusions: Cup-on-cup technique is a valid and safe solution for reconstruction of selected Paprosky type IIIA and IIIB bone defects with satisfactory clinical and radiographic results at short-term and mid-term follow-up. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|