The Modular Cup-in-Cup Construct in Revision Total Hip Arthroplasty

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2026-08-01 Epub Date: 2026-08-11 DOI:10.1016/j.artd.2026.102114

Ryan C. Palmer MD, McKenzie Culler MD, Pranit Kumaran BS, Donald B. Longjohn MD, Daniel A. Oakes MD, Nathanael D. Heckmann MD

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引用次数: 0

Abstract

Background

The modular cup-in-cup technique, in which a modular primary acetabular component is cemented into a highly porous monobloc tantalum revision shell, provides the intraoperative flexibility to change bearings if subsequent re-revision is required. This study seeks to characterize the early outcomes of this technique.

Methods

A single-center retrospective review was performed of all patients who underwent revision total hip arthroplasty (rTHA) utilizing a modular acetabular component cemented into a highly porous monobloc tantalum revision shell. Preoperative and postoperative radiographs were assessed to quantify bone loss, cup position, and aseptic loosening. All-cause reoperation, revision for aseptic loosening, and revision for instability were estimated using the Kaplan–Meier method.

Results

In total, 27 hips were identified with a mean follow-up of 21.6 months. The most common indication for revision was aseptic loosening (48.1%). Preoperatively, 16 (59.3%) hips had Paprosky 3A defects, 7 (25.9%) had Paprosky 3B, 2 (7.4%) had Paprosky 2C defects, and 1 (3.7%) had a Paprosky 2A defect. In total, 4 (14.8%) patients underwent reoperation, 3 (11.1%) for instability and 1 (3.7%) for irrigation and debridement. All patients revised for instability were converted from a dual mobility articulation to a constrained liner. No radiographic loosening was observed at final follow-up. Estimated 3-year survivorships for all-cause reoperation and revision for instability were 84.6% (95% confidence interval: 46.6-95.6%) and 88.5% (95% confidence interval, 48.8-97.6%), respectively.

Conclusions

The modular cup-in-cup technique is a viable option for rTHA patients at increased risk of instability. This technique provides surgeons the flexibility to exchange the articulation if recurrent instability occurs.

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模组化杯中杯结构在全髋关节置换术中的应用

模组化杯中杯技术，将一个模组化的初级髋臼部件粘合到一个高度多孔的单块钽修复壳中，如果需要后续的重新修复，则提供术中更换轴承的灵活性。本研究旨在描述该技术的早期结果。方法对所有接受全髋关节置换术（rTHA）翻修术的患者进行单中心回顾性分析，采用模块化髋臼假体胶合成高多孔单块钽翻修壳。术前和术后x线片评估量化骨丢失，杯位和无菌性松动。使用Kaplan-Meier方法估计全因再手术、无菌性松动翻修和不稳定翻修。结果共发现27例髋关节，平均随访21.6个月。最常见的改良指征是无菌性松动（48.1%）。术前papprosky 3A缺损16例（59.3%），papprosky 3B缺损7例（25.9%），papprosky 2C缺损2例（7.4%），papprosky 2A缺损1例（3.7%）。再手术4例（14.8%），不稳定3例（11.1%），冲洗清创1例（3.7%）。所有因不稳定而进行翻修的患者均从双活动关节转换为受限衬套。最后随访时未见影像学松动。全因再手术和不稳定翻修的3年生存率分别为84.6%（95%可信区间：46.6-95.6%）和88.5%（95%可信区间：48.8-97.6%）。结论模块化杯中杯技术是rTHA患者不稳定风险增加的可行选择。这项技术为外科医生在复发性不稳定发生时更换关节提供了灵活性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.