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International Orthopaedics

Open Access 27-09-2024 | Hip-TEP | Original Paper

Reconstruction of severe acetabular defects (Paprosky type III A) in total hip arthroplasty using modular tantalum augments in combination with a cemented cup

Authors: David Spranz, Lisa-Marie Müller, Raphael Trefzer, Pit Hetto, Timo Nees, Tobias Renkawitz, Tilman Walker, Tobias Reiner

Published in: International Orthopaedics

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Abstract

Purpose

Acetabular defect reconstruction can be a complex and challenging surgical procedure, with stable long-term fixation of the implants remaining the ultimate goal. The purpose of this study was (1) to evaluate the radiological and clinical outcome of complex acetabular reconstruction surgery with the use of modular tantalum TM augments in combination with cemented revision cups; (2) to investigate blood tantalum concentrations in these patients; and (3) to report complications and mechanisms of failure related to this procedure at mid-term follow-up (mean 4.5 years).

Methods

We retrospectively reviewed 29 patients (29 hips) with severe acetabular bone loss (Paprosky type III A) reconstructed using a modular tantalum TM augment in combination with a cemented cup. We evaluated the implant survival and the radiological and clinical outcomes after a mean follow-up of 4.5 years (SD 2.2; range 8.4 – 2.1 years) using patient reported outcome scores (PROMs). Blood samples were analysed regarding tantalum concentration and compared with a control group.

Results

The cumulative survival rate at 4.5 years with the endpoint “revision of the acetabular component for any reason” was 96.2% (95% Confidence Interval 75.7–99.5). The PROMs improved significantly up to the latest follow-up, and radiographic data showed only one patient with signs of initial implant migration with a broken screw and a change of the position of the augment and the cup. Mean blood tantalum concentrations were significantly higher in the study group (0.16 µg/L) compared to the control group (0.002 µg/L) (P < 0.001).

Conclusions

This study has demonstrated good mid-term (mean 4.5 years) clinical and radiological outcomes of modular tantalum TM augments in combination with a cemented cup for the reconstruction of major acetabular defects. Mean blood tantalum concentrations were increased in patients with stable tantalum implants compared to healthy controls.
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Metadata
Title
Reconstruction of severe acetabular defects (Paprosky type III A) in total hip arthroplasty using modular tantalum augments in combination with a cemented cup
Authors
David Spranz
Lisa-Marie Müller
Raphael Trefzer
Pit Hetto
Timo Nees
Tobias Renkawitz
Tilman Walker
Tobias Reiner
Publication date
27-09-2024
Publisher
Springer Berlin Heidelberg
Keywords
Hip-TEP
Hip-TEP
Published in
International Orthopaedics
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-024-06334-x