Can porous tantalum acetabular cups and augments restore the hip centre of rotation in revision hip arthroplasty? Long-term results.

Can porous tantalum acetabular cups and augments restore the hip centre of rotation in revision hip arthroplasty? Long-term results.

Authors

Keywords:

revision hip arthroplasty, tantalum cup, bone defect, centre of rotation

Abstract

Background and aim: Loss of bone stock is the main problem in revision hip arthroplasty. Porous tantalum cups and augment constructs are possible solutions. The aim of this study was to describe results at an average follow-up of 10 years using these cups.

Methods: 25 patients underwent to revision hip arthroplasty with porous tantalum cups. Acetabular bone defects were classified according to Paprosky’s in type II and III. All patients were reviewed clinically and radiographically at an average follow-up of 10 years (range 8.5 to 13 years). Changes in inclination angle of the cup and position of the hip centre of rotation (COR - measured and calculated using Pierchon’s method), and possible periacetabular radiolucency lines were assessed.

Results: A statistically significant improvement in Harris Hip Score and hip range of motion was observed. The hip COR had been lowered by 19.33 mm after revision and no changes in COR position had been measured at follow-up. Kaplan-Meier survivorship was 100% at an average follow-up of 10 years, considering acetabular revision for any reasons as primary endpoint. 88% of patients was satisfied. Complications were 3 dislocations, 4 asymptomatic heterotopic ossifications and 1 partial reabsorption of greater trochanter.

Conclusions: Porous tantalum cups and augments can be considered a valid solution in acetabular revisions for addressing massive bone defects and restoring the hip COR.

Author Biography

Chiara Concina, Department of Orthopaedics and Traumatology - San Polo Hospital - Monfalcone (GO)

Department of Orthopaedics and Traumatology

References

Sporer SM, Paprosky WG, O'Rourke MR. Managing bone loss in acetabular revision. J Bone Joint Surg Am 2005; 87: 1620-30.

Swedish Hip Arthroplasty Register – Annual Report 2010

Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89: 780-5.

Jones CP, Lachiewicz PF. Factors influencing the longer-term survival of uncemented acetabular components used in total hip revisions. J Bone Joint Surg Am 2004; 86 (2): 342-7.

Meneghini RM, Meyer C, Buckley CA, Hanssen AD, Lewallen DG. Mechanical stability of novel highly porous metal acetabular components in revision total hip arthroplasty. J Arthroplasty 2010; 25: 337-41.

Sternheim A, Backstein D, Kuzyk PR, Goshua G, Berkovich Y, Safir O, Gross AE. Porous metal revision shells for management of contained acetabular bone defects at a mean follow-up of six years: a comparison between up to 50% bleeding host bone contact and more than 50% contact. J Bone Joint Surg Br 2012; 94: 158-62.

Jeong M, Kim HJ, Lim SJ, Moon YW, Park YS. Revision Total Hip Arthroplasty Using Tantalum Augment in Patients with Paprosky III or IV Acetabular Bone Defects: A Minimum 2-year Follow Up Study. Hip Pelvis 2016; 28: 98-103.

Pierchon F, Migaud H, Duquennoy A, Fontaine C. Radiologic evaluation of the rotation center of the hip. Rev Chir Orthop Reparatrice Appar Mot 1993; 79: 281-4. French.

Dearborn JT, Harris WH. Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty 2000; 15: 8-15.

DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976; 121: 20-32.

Doehring TC, Rubash HE, Dore DE. Micromotion measurements with hip center and modular neck length alterations. Clin Orthop Relat Res 1999; (362): 230-9.

Lachiewicz PF, O'Dell JA. Tantalum Components in Difficult Acetabular Revisions Have Good Survival at 5 to 10 Years: Longer Term Followup of a Previous Report. Clin Orthop Relat Res 2018; 476: 336-42.

Skyttä ET, Eskelinen A, Paavolainen PO, Remes VM. Early results of 827 trabecular metal revision shells in acetabular revision. J Arthroplasty 2011; 26: 342-5.

Manley MT, Capello WN, D'Antonio JA, Edidin AA, Geesink RG. Fixation of acetabular cups without cement in total hip arthroplasty. A comparison of three different implant surfaces at a minimum duration of follow-up of five years. J Bone Joint Surg Am 1998; 80: 1175-85.

Sternheim A, Abolghasemian M, Safir OA, Backstein D, Gross AE, Kuzyk PR. A long-term survivorship comparison between cemented and uncemented cups with shelf grafts in revision total hip arthroplasty after dysplasia. J Arthroplasty 2013; 28: 303-8.

Garosi P, Marconi G, Bruno E, Flamur V. Le revisioni acetabolari con cemento in compressione armato nei difetti di grado II e III dell’AIR - Lo Scalpello – OTODI Educational 2009; 23: 88-94.

Pollock FH, Whiteside LA. The fate of massive allografts in total hip acetabular revision surgery. J Arthroplasty 1992; 7: 271-6.

Kosashvili Y, Safir O, Backstein D, Lakstein D, Gross AE. Salvage of failed acetabular cages by nonbuttressed trabecular metal cups. Clin Orthop Relat Res 2010; 468: 466-71.

Del Gaizo DJ, Kancherla V, Sporer SM, Paprosky WG. Tantalum augments for Paprosky IIIA defects remain stable at midterm followup. Clin Orthop Relat Res 2012; 470: 395-401.

Fernández-Fairen M, Murcia A, Blanco A, Meroño A, Murcia A Jr, Ballester J. Revision of failed total hip arthroplasty acetabular cups to porous tantalum components: a 5-year follow-up study. J Arthroplasty 2010; 25: 865-72.

Brüggemann A, Fredlund E, Mallmin H, Hailer NP. Are porous tantalum cups superior to conventional reinforcement rings? Acta Orthop 2017; 88: 35-40.

Waterson HB, Whitehouse MR, Greidanus NV, Garbuz DS, Masri BA, Duncan CP. Revision for adverse local tissue reaction following metal-on-polyethylene total hip arthroplasty is associated with a high risk of early major complications. Bone Joint J 2018; 100-B (6): 720-4.

Lee PT, Raz G, Safir OA, Backstein DJ, Gross AE. Long-term results for minor column allografts in revision hip arthroplasty. Clin Orthop Relat Res 2010; 468: 3295-3303.

Downloads

Published

10-03-2022

How to Cite

1.
Concina C, Crucil M, Gherlinzoni F. Can porous tantalum acetabular cups and augments restore the hip centre of rotation in revision hip arthroplasty? Long-term results. Acta Biomed [Internet]. 2022 Mar. 10 [cited 2024 Jul. 14];92(S3):e2021549. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/12398