Comparing Short-Term Clinical Outcomes and Survivorship of Complex Revision Total Hip Arthroplasty: Custom Triflange Acetabular Implants Vs Standard Cage Reconstruction

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2026-10-01 Epub Date: 2026-10-07 DOI:10.1016/j.artd.2026.102170

Luke G. Menken DO, McKenzie A. Mayer BS, Ian S. Hong MD, Nicholas T. Andriani DO, Mason Vialonga MD, Christian G. Zapf BS, Jaclyn M. Jankowski DO, Frank A. Liporace MD, Richard S. Yoon MD

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引用次数: 0

Abstract

Background

Complex revision total hip arthroplasty poses challenges in cases of severe acetabular bone loss, pelvic discontinuity, or multiple prior revision total hip arthroplasties. This study compares clinical outcomes and implant survivorship between custom triflange acetabular implants (CTAIs) and standard off-the-shelf cup-cage constructs.

Methods

Between 2016 and 2022, our registry was screened for consecutive patients who received either a CTAI or an off-the-shelf cup-cage construct. A retrospective review assessed patient characteristics, perioperative data, and postoperative outcomes using radiographs and follow-up notes. Primary outcomes were postoperative mortality and reoperation rates. Secondary outcomes included implant migration, bony remodeling, and patient-reported outcomes using Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOSJR). Kaplan–Meier survival analysis assessed mortality-free survival and implant survivorship. Univariate and multivariate analyses was conducted to determine associations between preoperative variables and postoperative outcomes.

Results

Among 787 screened patients, 18 met inclusion criteria. Fourteen (78%) had Paprofsky type 3A (28%) or 3B (50%) defects. Eleven (61%) patients received a CTAI, while 7 (39%) received standard off-the-shelf cup-cage constructs. The ΔHOOSJR scores were 37.7 ± 42.4 for off-the-shelf cup-cage constructs and 48.7 ± 30.8 for CTAI, with no significant difference (P = .531). Two (11%) patients required revision for periprosthetic joint infection, and 4 (22%) expired. Kaplan–Meier survival analysis revealed 75.2% mortality-free survivorship and 78% implant survivorship at 4 years.

Conclusions

Off-the-shelf cup-cage constructs and CTAIs demonstrated comparable short-term clinical outcomes and implant survivorship in this cohort of patients undergoing complex revision THA. Implant selection may therefore be guided by patient-specific factors and surgeon preference.

查看原文本刊更多论文

比较复杂翻修全髋关节置换术的短期临床结果和生存期：定制三法兰髋臼植入物与标准髋臼重建

复杂翻修全髋关节置换术在严重髋臼骨丢失、骨盆不连续性或多次翻修全髋关节置换术的病例中提出了挑战。本研究比较了定制的三法兰髋臼植入物（CTAIs）和标准的现成杯笼植入物的临床结果和种植成活率。方法在2016年至2022年期间，我们的注册表筛选了连续接受CTAI或现成杯笼结构的患者。回顾性评估患者特征、围手术期数据和术后结果，使用x线片和随访记录。主要结果为术后死亡率和再手术率。次要结局包括植入物迁移、骨重塑和患者报告的髋关节残疾和骨关节炎关节置换术结局评分（HOOSJR）。Kaplan-Meier生存分析评估无死亡生存和植入物生存。进行单因素和多因素分析以确定术前变量与术后结果之间的关系。结果在787例筛查患者中，18例符合纳入标准。14例（78%）有Paprofsky型3A（28%）或3B（50%）缺陷。11例（61%）患者接受了CTAI， 7例（39%）患者接受了标准的现成杯笼结构。现成杯笼组的ΔHOOSJR得分为37.7±42.4分，CTAI组为48.7±30.8分，差异无统计学意义（P = .531）。2例（11%）患者因假体周围关节感染需要翻修，4例（22%）患者死亡。Kaplan-Meier生存分析显示，4年无死亡生存率为75.2%，植入物生存率为78%。结论：在接受复杂翻修THA的患者中，现成的杯架结构和CTAIs具有相当的短期临床结果和种植体存活率。因此，种植体的选择可以根据患者的具体因素和外科医生的偏好来指导。

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.