Skip to main content
Top
Published in: International Orthopaedics 4/2013

01-04-2013 | Original Paper

Modular acetabular reconstructive cup in acetabular revision total hip arthroplasty at a minimum ten year follow-up

Authors: Takashi Sakai, Kenji Ohzono, Takashi Nishii, Masaki Takao, Hidenobu Miki, Nobuo Nakamura, Nobuhiko Sugano

Published in: International Orthopaedics | Issue 4/2013

Login to get access

Abstract

Purpose

Modular acetabular reconstructive cups have been introduced in an attempt to offer initial rigid fixation by iliac lag screws and ischial pegs, to support bone grafts with a flanged metal socket, and to restore original hip center in acetabular revision. The purpose of this study was to clarify minimum ten year follow-up results of this cup system with morsellised allografts in revision cases.

Methods

We retrospectively investigated 54 acetabular revisions at a mean of 11 years (range, ten to 14 years). The indications were Paprosky’s type 2B (eight hip), 2C (eight hips), 3A (23 hips), 3B (nine hips), and 4 (six hips).

Results

Using aseptic loosening as the endpoints, the survival rate was 89.3 % (95 % CI 81–98). Radiographically, one type 3A hip, three type 3B hips and one type 4 hip showed aseptic loosening while no type 2 hips or no cemented cups showed loosening.

Conclusions

The modular reconstructive cups for acetabular revision showed bone stock restoration and stable implantation.
Literature
1.
go back to reference Comba F, Buttaro M, Pusso R, Piccaluga F (2006) Acetabular reconstruction with impacted bone allografts and cemented acetabular components. A 2- to 13-year follow-up study of 142 aseptic revisions. J Bone Joint Surg Br 88:865–869PubMedCrossRef Comba F, Buttaro M, Pusso R, Piccaluga F (2006) Acetabular reconstruction with impacted bone allografts and cemented acetabular components. A 2- to 13-year follow-up study of 142 aseptic revisions. J Bone Joint Surg Br 88:865–869PubMedCrossRef
2.
go back to reference Garcia-Cimbrelo E, Cruz-Pardos A, Garcia-Rey E, Ortega-Chamarro J (2010) The survival and fate of acetabular reconstruction with impaction grafting for large defects. Clin Orthop Relat Res 468:3304–3313PubMedCrossRef Garcia-Cimbrelo E, Cruz-Pardos A, Garcia-Rey E, Ortega-Chamarro J (2010) The survival and fate of acetabular reconstruction with impaction grafting for large defects. Clin Orthop Relat Res 468:3304–3313PubMedCrossRef
3.
go back to reference Jeffery M, Scott G, Freeman M (2003) Failure of an uncemented non-porous metal-backed prosthesis with augmentation using impacted allograft for acetabular revision. 12- to 17-year results. J Bone Joint Surg Br 85:182–186PubMedCrossRef Jeffery M, Scott G, Freeman M (2003) Failure of an uncemented non-porous metal-backed prosthesis with augmentation using impacted allograft for acetabular revision. 12- to 17-year results. J Bone Joint Surg Br 85:182–186PubMedCrossRef
4.
go back to reference Kawanabe K, Akiyama H, Onishi E, Nakamura T (2007) Revision total hip replacement using the Kerboull acetabular reinforcement device with morsellised or bulk graft. J Bone Joint Surg Br 89:26–31PubMedCrossRef Kawanabe K, Akiyama H, Onishi E, Nakamura T (2007) Revision total hip replacement using the Kerboull acetabular reinforcement device with morsellised or bulk graft. J Bone Joint Surg Br 89:26–31PubMedCrossRef
5.
go back to reference Okano K, Miyata N, Enomoto H, Osaki M, Shindo H (2010) Revision with impacted bone allografts and the Kerboull cross plate for massive bone defect of the acetabulum. J Arthroplasty 25:594–599PubMedCrossRef Okano K, Miyata N, Enomoto H, Osaki M, Shindo H (2010) Revision with impacted bone allografts and the Kerboull cross plate for massive bone defect of the acetabulum. J Arthroplasty 25:594–599PubMedCrossRef
6.
go back to reference Oonishi H, Iwaki Y, Kin N, Kushitani S, Murata N, Wakitani S, Imoto K (1997) Hydroxyapatite in revision of total hip replacements with massive acetabular defects. J Bone Joint Surg Br 79:87–92PubMedCrossRef Oonishi H, Iwaki Y, Kin N, Kushitani S, Murata N, Wakitani S, Imoto K (1997) Hydroxyapatite in revision of total hip replacements with massive acetabular defects. J Bone Joint Surg Br 79:87–92PubMedCrossRef
7.
go back to reference Sakai T, Ohzono K, Nishii T, Miki H, Takao M, Sugano N (2010) Grafting with hydroxyapatite grannules for defects of acetabular bone at revision total hip replacement. A minimum ten-year follow-up. J Bone Joint Surg Br 92:1215–1221PubMed Sakai T, Ohzono K, Nishii T, Miki H, Takao M, Sugano N (2010) Grafting with hydroxyapatite grannules for defects of acetabular bone at revision total hip replacement. A minimum ten-year follow-up. J Bone Joint Surg Br 92:1215–1221PubMed
8.
go back to reference Schreurs BW, Keurentjes JC, Gardeniers JWM, Verdonschot N, Slooff TJJH, Veth RPH (2009) Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component. A 20-to 25-year follow-up. J Bone Joint Surg Br 91:1148–1153PubMedCrossRef Schreurs BW, Keurentjes JC, Gardeniers JWM, Verdonschot N, Slooff TJJH, Veth RPH (2009) Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component. A 20-to 25-year follow-up. J Bone Joint Surg Br 91:1148–1153PubMedCrossRef
9.
go back to reference Sporer SM, O’Rourke M, Chong P, Paprosky WG (2005) The use of structural distal femoral allografts for acetabular reconstruction. Average 10-year follow-up. J Bone Joint Surg Am 87:760–765PubMedCrossRef Sporer SM, O’Rourke M, Chong P, Paprosky WG (2005) The use of structural distal femoral allografts for acetabular reconstruction. Average 10-year follow-up. J Bone Joint Surg Am 87:760–765PubMedCrossRef
10.
go back to reference Sudo A, Hasegawa M, Fukuda A, Kawamura G, Muraki M, Uchida A (2007) Acetabular reconstruction using a cementless cup and hydroxyapatite granules. J Arthroplasty 22:828–832PubMedCrossRef Sudo A, Hasegawa M, Fukuda A, Kawamura G, Muraki M, Uchida A (2007) Acetabular reconstruction using a cementless cup and hydroxyapatite granules. J Arthroplasty 22:828–832PubMedCrossRef
11.
go back to reference Tanaka C, Shikata J, Ikenaga M, Takahashi M (2003) Acetabular reconstruction using a Kerboull-type acetabular reinforcement device and hydroxyapatite granules. A 3- to 8- year follow-up study. J Arthroplasty 18:719–725PubMedCrossRef Tanaka C, Shikata J, Ikenaga M, Takahashi M (2003) Acetabular reconstruction using a Kerboull-type acetabular reinforcement device and hydroxyapatite granules. A 3- to 8- year follow-up study. J Arthroplasty 18:719–725PubMedCrossRef
12.
go back to reference van Haaren EH, Heyligers IC, Alexander FGM, Wuisman PIJM (2007) High rate of failure of impaction grafting in large acetabular defects. J Bone Joint Surg Br 89:296–300PubMedCrossRef van Haaren EH, Heyligers IC, Alexander FGM, Wuisman PIJM (2007) High rate of failure of impaction grafting in large acetabular defects. J Bone Joint Surg Br 89:296–300PubMedCrossRef
13.
go back to reference Wang JW, Fong CY, Su YS, Yu HN (2006) Acetabular revision with morsellised allogenic bone graft and a cemented metal-backed component. J Bone Joint Surg Br 88:586–591PubMedCrossRef Wang JW, Fong CY, Su YS, Yu HN (2006) Acetabular revision with morsellised allogenic bone graft and a cemented metal-backed component. J Bone Joint Surg Br 88:586–591PubMedCrossRef
14.
go back to reference Sadoghi P, Schröder C, Fottner A, Steinbrück A, Betz O, Müller PE, Jansson V, Hölzer A (2012) Application and survival curve of total hip arthroplasties: a systematic comparative analysis using worldwide hip arthroplasty registers. Int Orthop 36:2197–2203PubMedCrossRef Sadoghi P, Schröder C, Fottner A, Steinbrück A, Betz O, Müller PE, Jansson V, Hölzer A (2012) Application and survival curve of total hip arthroplasties: a systematic comparative analysis using worldwide hip arthroplasty registers. Int Orthop 36:2197–2203PubMedCrossRef
15.
go back to reference Paprosky WG, Perona PG, Lawrence JM (1994) Acetabular defect classification and surgical reconstruction in revision arthroplasty: a six year follow-up evaluation. J Arthroplasty 9:33–44PubMedCrossRef Paprosky WG, Perona PG, Lawrence JM (1994) Acetabular defect classification and surgical reconstruction in revision arthroplasty: a six year follow-up evaluation. J Arthroplasty 9:33–44PubMedCrossRef
16.
go back to reference Babis GC, Sakellariou VI, Chatziantoniou AN, Soucacos PN, Megas P (2011) High complication rate in reconstruction of Paprosky type IIIa acetabular defects using an oblong implant with modular side plates and a hook. J Bone Joint Surg Br 93:1592–1596PubMedCrossRef Babis GC, Sakellariou VI, Chatziantoniou AN, Soucacos PN, Megas P (2011) High complication rate in reconstruction of Paprosky type IIIa acetabular defects using an oblong implant with modular side plates and a hook. J Bone Joint Surg Br 93:1592–1596PubMedCrossRef
17.
go back to reference Friesenbichler J, Schwarzkopf R, Sadoghi P, Marwin SE, Glehr M, Maurer-Ertl W, Leithner A (2012) Failure rate of a rotating hinge knee design due to yoke fracture of the hinged tibial insert: a retrospective data analysis and review of the literature. Int Orthop 36:993–998PubMedCrossRef Friesenbichler J, Schwarzkopf R, Sadoghi P, Marwin SE, Glehr M, Maurer-Ertl W, Leithner A (2012) Failure rate of a rotating hinge knee design due to yoke fracture of the hinged tibial insert: a retrospective data analysis and review of the literature. Int Orthop 36:993–998PubMedCrossRef
18.
go back to reference Lingaraj K, Teo YH, Bergman N (2009) The management of severe acetabular bone defects in revision hip arthroplasty using modular porous metal components. J Bone Joint Surg Br 91:1555–1560PubMedCrossRef Lingaraj K, Teo YH, Bergman N (2009) The management of severe acetabular bone defects in revision hip arthroplasty using modular porous metal components. J Bone Joint Surg Br 91:1555–1560PubMedCrossRef
19.
go back to reference Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed
20.
go back to reference Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM (2005) Reconstructed hip joints position and abductor muscle strength after total hip arthroplasty. J Arthroplasty 20:414–420PubMedCrossRef Asayama I, Chamnongkich S, Simpson KJ, Kinsey TL, Mahoney OM (2005) Reconstructed hip joints position and abductor muscle strength after total hip arthroplasty. J Arthroplasty 20:414–420PubMedCrossRef
21.
go back to reference Nunn D, Freeman MAR, Hill PF, Evans SJW (1989) The measurement of migration of the acetabular component of hip prostheses. J Bone Joint Surg Br 71:629–631PubMed Nunn D, Freeman MAR, Hill PF, Evans SJW (1989) The measurement of migration of the acetabular component of hip prostheses. J Bone Joint Surg Br 71:629–631PubMed
22.
go back to reference Ochs BG, Schmid U, Rieth J, Ateschrang A, Weise K, Ochs U (2008) Acetabular bone reconstruction in revision arthroplasty. A comparison of freeze-dried, irradiated and chemically-treated allograft vitalized with autologous marrow versus frozen non-irradiated allograft. J Bone Joint Surg Br 90:1164–1171PubMedCrossRef Ochs BG, Schmid U, Rieth J, Ateschrang A, Weise K, Ochs U (2008) Acetabular bone reconstruction in revision arthroplasty. A comparison of freeze-dried, irradiated and chemically-treated allograft vitalized with autologous marrow versus frozen non-irradiated allograft. J Bone Joint Surg Br 90:1164–1171PubMedCrossRef
23.
go back to reference DeLee JG, Charnley J (1976) Radiographic demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32PubMed DeLee JG, Charnley J (1976) Radiographic demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32PubMed
24.
go back to reference Hoenig JM, Heisey DM (2001) The abuse of power: the pervasive fallacy of power calculations for data analysis. Am Stat 55:19–24CrossRef Hoenig JM, Heisey DM (2001) The abuse of power: the pervasive fallacy of power calculations for data analysis. Am Stat 55:19–24CrossRef
25.
go back to reference Takao M, Nakamura N, Ohzono K, Sakai T, Nishii T, Sugano N (2011) The results of a press-fit-only technique for acetabular fixation in hip dysplasia. J Arthroplasty 26:562–568PubMedCrossRef Takao M, Nakamura N, Ohzono K, Sakai T, Nishii T, Sugano N (2011) The results of a press-fit-only technique for acetabular fixation in hip dysplasia. J Arthroplasty 26:562–568PubMedCrossRef
26.
go back to reference van der Donk S, Buma P, Slooff TJJH, Gardeniers JWM, Schreurs BW (2002) Incorporation of morsellised bone grafts: a study of 24 acetabular biopsy specimens. Clin Orthop Relat Res 396:131–141PubMedCrossRef van der Donk S, Buma P, Slooff TJJH, Gardeniers JWM, Schreurs BW (2002) Incorporation of morsellised bone grafts: a study of 24 acetabular biopsy specimens. Clin Orthop Relat Res 396:131–141PubMedCrossRef
27.
go back to reference Winter E, Piert M, Volkmann R, Maurer F, Eingartner C, Weise K, Weller S (2001) Allogeneic cancellous bone graft and a Burch-Schneider ring for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg Am 83:862–867PubMed Winter E, Piert M, Volkmann R, Maurer F, Eingartner C, Weise K, Weller S (2001) Allogeneic cancellous bone graft and a Burch-Schneider ring for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg Am 83:862–867PubMed
Metadata
Title
Modular acetabular reconstructive cup in acetabular revision total hip arthroplasty at a minimum ten year follow-up
Authors
Takashi Sakai
Kenji Ohzono
Takashi Nishii
Masaki Takao
Hidenobu Miki
Nobuo Nakamura
Nobuhiko Sugano
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 4/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-1818-4

Other articles of this Issue 4/2013

International Orthopaedics 4/2013 Go to the issue