Destruction of acetabular bone caused by early failure of a constrained acetabular component

2001 ◽  
Vol 16 (7) ◽  
pp. 938-941 ◽  
Author(s):  
Hiroshi Ito ◽  
Akio Minami ◽  
Eiji Kondo ◽  
Masaki Fujita ◽  
Yuji Ubayama ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Early Failure ◽  
Acetabular Bone ◽  
Constrained Acetabular Component

Impaction bone grafting in hip re-revision surgery

2021 ◽  
Vol 103-B (3) ◽  
pp. 492-499
Author(s):  
Eduardo Garcia-Rey ◽  
Laura Saldaña ◽  
Eduardo Garcia-Cimbrelo
Keyword(s):  
Aseptic Loosening ◽  
Acetabular Component ◽  
Revision Surgery ◽  
Bone Grafting ◽  
Bone Defects ◽  
Bone Stock ◽  
Impaction Bone Grafting ◽  
Acetabular Bone ◽  
Acetabular Bone Defects

Aims Bone stock restoration of acetabular bone defects using impaction bone grafting (IBG) in total hip arthroplasty may facilitate future re-revision in the event of failure of the reconstruction. We hypothesized that the acetabular bone defect during re-revision surgery after IBG was smaller than during the previous revision surgery. The clinical and radiological results of re-revisions with repeated use of IBG were also analyzed. Methods In a series of 382 acetabular revisions using IBG and a cemented component, 45 hips (45 patients) that had failed due to aseptic loosening were re-revised between 1992 and 2016. Acetabular bone defects graded according to Paprosky during the first and the re-revision surgery were compared. Clinical and radiological findings were analyzed over time. Survival analysis was performed using a competing risk analysis. Results Intraoperative bone defect during the initial revision included 19 Paprosky type IIIA and 29 Paprosky type IIIB hips; at re-revision, seven hips were Paprosky type II, 27 type IIIA and 11 were type IIIB (p = 0.020). The mean preoperative Harris Hip Score was 45.4 (SD 6.4), becoming 80.7 (SD 12.7) at the final follow-up. In all, 12 hips showed radiological migration of the acetabular component, and three required further revision surgery. The nine-year cumulative failure incidence (nine patients at risk) of the acetabular component for further revision surgery was 9.6% (95% confidence interval (CI) 2.9 to 21.0) for any cause, and 7.5% (95% CI 1.9 to 18.5) for aseptic loosening. Hips with a greater hip height had a higher risk for radiological migration (odds ratio 1.09, 95% CI 1.02 to 1.17; p = 0.008). Conclusion Bone stock restoration can be obtained using IBG in revision hip surgery. This technique is also useful in re-revision surgery; however, a better surgical technique including a closer distance to hip rotation centre could decrease the risk of radiological migration of the acetabular component. A longer follow-up is required to assess potential fixation deterioration. Cite this article: Bone Joint J 2021;103-B(3):492–499.

The use of a constrained acetabular component for recurrent dislocation

2003 ◽  
Vol 18 (3) ◽  
pp. 250-258 ◽  
Author(s):  
Gary S. Shapiro ◽  
Daniel E. Weiland ◽  
David C. Markel ◽  
Douglas E. Padgett ◽  
Thomas P. Sculco ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Recurrent Dislocation ◽  
Constrained Acetabular Component

scholarly journals Salvaging Unstable or Recurrent Dislocating Total Hip Arthroplasty with the Constrained Acetabular Component

2002 ◽  
Vol 10 (2) ◽  
pp. 165-169 ◽  
Author(s):  
DA Stanton ◽  
WJ Bruce ◽  
JA Goldberg ◽  
W Walsh
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Recurrent Dislocation ◽  
Total Hip ◽  
Hip Replacements ◽  
The Mean ◽  
Acetabular Components ◽  
Constrained Acetabular Component

Purpose. To review cases of implantation of constraining acetabular components for unstable or recurrent dislocating total hip arthroplasty at the Department of Orthopaedics, Concord Hospital, Sydney. Methods. A retrospective analysis was performed on prospectively collected data of 13 consecutively enrolled patients. Results. From 1989 to 2000, 13 constraining acetabular components were implanted into 13 patients as a revision procedure. The surgical approach for the implantation of the constrained liner was posterolateral in 11 cases; a modified Hardinge approach was applied in 2 cases. The mean clinical follow-up duration was 43 months (range, 14–121 months) and the mean age at the time of surgery was 73 years (range, 52–84 years). No patients were lost to follow-up. Indications for using the constrained acetabular component were recurrent dislocation in revision hip replacements (n=8), and intra-operative instability (n=5). There were no episodes of dislocation of the constrained arthroplasty. In 7 cases, the constrained component was implanted into a previously well-fixed shell. Conclusion. We recommend the judicious use of the constrained component in cases of hip instability during or after total hip arthroplasty when other methods are not successful.

scholarly journals Optimizing Acetabular Component Bone Ingrowth: The Wedge-Fit Bone Preparation Method

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Dani M. Gaillard-Campbell ◽  
Thomas P. Gross
Keyword(s):  
Acetabular Component ◽  
Preparation Method ◽  
Bone Ingrowth ◽  
Hip Resurfacing ◽  
Outer Diameter ◽  
Preparation Technique ◽  
Acetabular Bone ◽  
Press Fit ◽  
Unexplained Pain ◽  
Clinical Problems

We investigate the efficacy of a modified acetabular bone-preparation technique in reducing the incidence of two clinical problems identified in hip resurfacing arthroplasty. The first issue is failure due to lack of bone ingrowth into the acetabular component. The second is a newly recognized phenomenon of early cup shift. We hypothesize that these issues might be resolved by using a “wedge-fit method”, in which the component wedges into the peripheral acetabular bone rather than bottoming out and potentially toggling on the apex of the cup. Prior to November 2011, all acetabula were reamed 1 mm under and prepared with a press-fit of the porous coated acetabular component. After November 2011, we adjusted reaming by bone density. In “soft bone” (T-score <-1.0), we underreamed acetabula by 1 mm less than the outer diameter of the cup, as was previously done in all cases. For T-scores greater than -1.0, we reamed line-to-line. Additionally, we began performing an “apex relief” starting June 2012 in all cases by removing 2 mm of apex bone with a small reamer after using the largest reamer. Failure of acetabular ingrowth occurred in 0.5% of cases before the wedge-fit method and <0.1% after. Rate of cup shift was reduced from 1.1% to 0.4%. The rate of unexplained pain between 2 and 4 years postoperatively also declined significantly from 2.6% to 1.3%. Our evidence suggests that wedge-fit acetabular preparation improves initial implant stability, leading to fewer cases of early cup shift, unexplained pain, and acetabular ingrowth failure.

The Constrained Acetabular Component for Hip Instability

2007 ◽  
Vol 22 (3) ◽  
pp. 377-382 ◽  
Author(s):  
Riaz J.K. Khan ◽  
Daniel Fick ◽  
Renuka Alakeson ◽  
Ming G. Li ◽  
Bo Nivbrant ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Hip Instability ◽  
Constrained Acetabular Component
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