{"title":"Rim-point-column-oriented algorithm in cementless acetabular reconstruction in revision total hip arthroplasty : a minimum five-year follow-up study.","authors":"Yong Huang, Yixin Zhou, Dejin Yang, Hao Tang, Wang Deng, Shaoyi Guo","doi":"10.1302/0301-620X.107B6.BJJ-2024-0940.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>The Paprosky acetabular defect classification and associated algorithms cannot adequately guide cementless acetabular reconstruction when using porous metal augments. We aimed to introduce a rim, points, and column (RPC)-orientated cementless acetabular reconstruction algorithm, and hypothesized that patients undergoing this treatment would demonstrate satisfactory mid-term clinical and radiological outcomes.</p><p><strong>Methods: </strong>We enrolled 114 patients (119 hips) who underwent revision total hip arthroplasty between April 2014 and November 2017 by a single surgeon. A minimum five-year radiological follow-up was available for 90 hips (75.6%), with mean clinical and radiological follow-up durations of 6.8 years (SD 0.9) and 6.3 years (SD 1.9), respectively.</p><p><strong>Results: </strong>Harris Hip Scores improved from 35.4 (SD 10.2) preoperatively to 86.0 (SD 10.3) postoperatively (p < 0.001). Fixation modes included rim fixation (33 hips; 27.7%), three-point fixation without point reconstruction (42 hips; 35.3%), three-point fixation with point reconstruction (40 hips; 33.6%), and three-point fixation with pelvic distraction (four hips; 3.4%). Medial wall reconstruction was performed in 20 patients (16.8%). All acetabular components were radiologically stable. Nine-year Kaplan-Meier survival rates for periprosthetic joint infection, any reoperation, and dissatisfaction were 98.28% (95% CI 88.38 to 99.76), 94.37% (95% CI 81.93 to 98.33), and 95.10% (95% CI 84.64 to 98.50), respectively.</p><p><strong>Conclusion: </strong>Acetabular component stability in cementless acetabular reconstruction relies on rim or three-point fixation, with anterior and posterior column continuity providing essential stability. Medial wall reconstruction complements fixation in the RPC algorithm, yielding satisfactory mid-term outcomes.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 6 Supple B","pages":"15-22"},"PeriodicalIF":4.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.107B6.BJJ-2024-0940.R1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: The Paprosky acetabular defect classification and associated algorithms cannot adequately guide cementless acetabular reconstruction when using porous metal augments. We aimed to introduce a rim, points, and column (RPC)-orientated cementless acetabular reconstruction algorithm, and hypothesized that patients undergoing this treatment would demonstrate satisfactory mid-term clinical and radiological outcomes.
Methods: We enrolled 114 patients (119 hips) who underwent revision total hip arthroplasty between April 2014 and November 2017 by a single surgeon. A minimum five-year radiological follow-up was available for 90 hips (75.6%), with mean clinical and radiological follow-up durations of 6.8 years (SD 0.9) and 6.3 years (SD 1.9), respectively.
Results: Harris Hip Scores improved from 35.4 (SD 10.2) preoperatively to 86.0 (SD 10.3) postoperatively (p < 0.001). Fixation modes included rim fixation (33 hips; 27.7%), three-point fixation without point reconstruction (42 hips; 35.3%), three-point fixation with point reconstruction (40 hips; 33.6%), and three-point fixation with pelvic distraction (four hips; 3.4%). Medial wall reconstruction was performed in 20 patients (16.8%). All acetabular components were radiologically stable. Nine-year Kaplan-Meier survival rates for periprosthetic joint infection, any reoperation, and dissatisfaction were 98.28% (95% CI 88.38 to 99.76), 94.37% (95% CI 81.93 to 98.33), and 95.10% (95% CI 84.64 to 98.50), respectively.
Conclusion: Acetabular component stability in cementless acetabular reconstruction relies on rim or three-point fixation, with anterior and posterior column continuity providing essential stability. Medial wall reconstruction complements fixation in the RPC algorithm, yielding satisfactory mid-term outcomes.
期刊介绍:
We welcome original articles from any part of the world. The papers are assessed by members of the Editorial Board and our international panel of expert reviewers, then either accepted for publication or rejected by the Editor. We receive over 2000 submissions each year and accept about 250 for publication, many after revisions recommended by the reviewers, editors or statistical advisers. A decision usually takes between six and eight weeks. Each paper is assessed by two reviewers with a special interest in the subject covered by the paper, and also by members of the editorial team. Controversial papers will be discussed at a full meeting of the Editorial Board. Publication is between four and six months after acceptance.