HIP International最新文献

{"title":"Outcomes associated with hip preservation using osteochondral allograft transplants and acetabular labrum reconstruction.","authors":"Kylee Rucinski, James L Cook, Cory R Crecelius, Brett D Crist","doi":"10.1177/11207000241288445","DOIUrl":"https://doi.org/10.1177/11207000241288445","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral allograft (OCA) transplantation with or without labral reconstruction is considered a hip preservation surgical treatment option for young, active patients. This study aims to report early outcomes for use of OCA and labrum allograft transplants for patients treated for symptomatic femoral head chondral damage and/or acetabular labrum deficiency after implementation of a comprehensive joint restoration approach.</p><p><strong>Methods: </strong>33 patients from a lifelong registry were included for analysis. Outcomes were compared for statistically significant (<i>p</i> < 0.05) differences based on graft preservation methodology (standard preservation [SP] vs. Missouri Osteochondral Preservation System [MOPS]), and based on surfaces treated (femoral head only, labrum only, or femoral head and labrum).</p><p><strong>Results: </strong>Mean follow-up duration was 44.8 (range 12-95) months. Success was documented in 28 (84.8%) patients. For the SP cohort, successful outcomes were documented in 5 cases (50%), while all 23 MOPS cases (100%) were deemed successful at least 1 year after surgery. Hip preservation surgeries performed using MOPS grafts were associated with significantly (<i>p</i> = 0.001; OR = 47x) higher success rates, including significant and clinically meaningful improvements in PROMs at 1 and 2 years after surgery. Revision was performed in 2 patients in the SP cohort and failure requiring total hip arthroplasty was documented in 3 SP patients. Mean time to revision or failure was 23.6 (range 4-43) months. The surfaces treated were significantly associated with failure when comparing patients undergoing a femoral head OCA with or without labral reconstruction to those undergoing labral reconstruction only (<i>p</i> = 0.03; OR = 8.3x).</p><p><strong>Conclusions: </strong>Patients with symptomatic femoral head cartilage loss and/or irreparable acetabular labrum deficiency undergoing femoral head OCA transplantation and/or labral reconstruction with meniscus allografts using MOPS-preserved tissues experienced statistically significant and clinically meaningful improvements in pain and function through at least 2 years after surgery.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and radiological outcomes and complications of bernese periacetabular osteotomy through modified Stoppa approach.","authors":"Deniz Akbulut, Mehmet Coskun","doi":"10.1177/11207000241280951","DOIUrl":"https://doi.org/10.1177/11207000241280951","url":null,"abstract":"<p><strong>Background: </strong>The Smith-Peterson approach and its modifications provide an extensive exposure and allow osteotomies through a single incision. However, the risk of complications increases when the quadrilateral surface, ischial and pubic osteotomy sites cannot be seen. This study aimed to evaluate the surgical characteristics, complications, and functional and radiological outcomes of patients with acetabular dysplasia who underwent Bernese periacetabular osteotomy (PAO) through modified Stoppa approach and plate-screw fixation.</p><p><strong>Methods: </strong>The study included 31 patients (41 hips) who had undergone PAO using a modified Stoppa approach. The characteristics of patients and the surgical procedure were described. The lateral centre-edge angle (LCEA) and Tönnis roof angle were evaluated in the radiological outcome evaluation. The modified Harris Hip Score (mHHS) was used to evaluate functional outcome. Furthermore, complications were described.</p><p><strong>Results: </strong>The mean age of the patients was 20.4 ± 9.0 years. Of the 31 patients, 21 underwent unilateral Bernese PAO and 10 underwent bilateral Bernese PAO. The mean follow-up period was 25.1 ± 8.8 months. Postoperatively, the mean mHHS improved significantly (68.8 ± 9.4 vs. 88.8 ± 10.0, <i>p</i> < 0.001). Postoperatively, the mean LCEA and Tönnis roof angle improved significantly (17.7 ± 6.0 vs. 42.2 ± 4.8, <i>p</i> < 0.001 for LCEA and 18.3 ± 5.5 vs. 8.0 ± 2.2, <i>p</i> < 0.001 for Tönnis roof angle). There was no significant correlation between preoperative to postoperative improvement in LCEA or Tönnis roof angle and improvement and mHHS (<i>p</i> > 0.005). 5 complications were identified: 1 transient sciatic nerve palsy, 1 external iliac vein injury, 1 infection, and 2 screw irritations of acetabulum.</p><p><strong>Conclusions: </strong>Performing Bernese PAO through a modified Stoppa approach with plate-screw fixation results in acceptable complication rates, immediate early weight-bearing opportunity, and improved functional and radiological outcomes in patients with acetabular dysplasia.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The inferior sacral iliac line as a horizontal reference plane in paediatric pelvic radiographs.","authors":"Thomas J Berault, John M Wyatt, Aaron A Olsen, Clark Mantooth, George C Balazs, Ashton H Goldman, Vanna J Rocchi","doi":"10.1177/11207000241283801","DOIUrl":"https://doi.org/10.1177/11207000241283801","url":null,"abstract":"<p><strong>Background: </strong>While often used, Hilgenreiner's line may not always be a reliable reference plane following triple innominate pelvic osteotomy or trauma to the triradiate cartilage. The inferior sacral-iliac line is a horizontal line connecting the sclerotic corners of the inferior sacral-iliac joints. This is a consistent landmark in the ossifying infant pelvis as well as the fully developed adult pelvis. The goal of this study was to determine if there is a difference in measurements between the inferior sacral-iliac line and Hilgenreiner's line in order to identify an alternative horizontal reference plane.</p><p><strong>Methods: </strong>3 reviewers (fellowship-trained paediatric orthopaedic surgeon, junior orthopaedic resident, senior orthopaedic resident) reviewed 100 paediatric non-osteotomized pelvises. The difference between Hilgenreiner's line and the inferior sacral-iliac line were measured and reported. Measurements were repeated a minimum of 48 hours apart, resulting in 600 comparisons between Hilgenreiner's line and the inferior sacral-iliac line. The standard error of measurement was calculated to assess the variation in measurements between each individual observer and the group as a whole.</p><p><strong>Results: </strong>The mean standard error of measurement between Hilgenreiner's line and the inferior sacral-iliac line was 0.44° (95% CI, ± 0.86). Reviewers 1-3 demonstrated a mean standard error of measurement of 0.38, 0.28, and 0.35 (95% CI, ± 0.74, 0.55, and 0.86) respectively. There was no statistically significant difference between reviewers (<i>p</i> > 0.05). Intra-observer reliability for reviewers 1, 2, and 3 was 0.64 (0.47-0.76), 0.75 (0.63-0.83), and 0.54 (0.32-0.69) respectively, with an inter-observer reliability of 0.42 (0.20-0.60) degrees.</p><p><strong>Conclusions: </strong>In this proof-of-concept study, the inferior sacral-iliac line was found to be an appropriate alternative to Hilgenreiner's line that is easily identifiable for all levels of orthopaedic training. Future inferior sacral-iliac line studies should demonstrate the reliability of multiple acetabular measurements, both pre- and post-osteotomy.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional single articulation constrained liners in revision hip arthroplasty: risk factors for failure and their combinations.","authors":"Rashid M Tikhilov, Nikolai N Efimov, Igor I Shubnyakov, Maksim Y Goncharov, Dmitrii V Stafeev, Vitalii V Karelkin","doi":"10.1177/11207000241282398","DOIUrl":"10.1177/11207000241282398","url":null,"abstract":"<p><strong>Background: </strong>Constrained liners (CLs) have been used in revision total hip arthroplasty (rTHA) with varying results. Relatively few studies have identified specific risk factors for failure. This study aimed to assess implant survivorship and complication rates, identify risk factors for constraint-related complications, and assess the effect of multiple factors present in a single case.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 101 rTHAs for various aseptic indications and as second-stage procedures for periprosthetic joint infection (PJI) utilising 2 models of conventional single-articulation CLs. We excluded 8 cases in which the liners were removed early due to PJI and assessed the risk factors for constraint-related complications in the remaining 93 cases. The mean follow-up duration for complication-free cases was 6.5 years (range 4.7-10.5 years).</p><p><strong>Results: </strong>The incidences of dislocation of a prosthetic head and loosening of the acetabular component were 19.8% and 5.0%, respectively. We also observed 8 cases where the locking ring of the liner was dislodged without dislocation (1 case required re-revision). The presence of factors related to impingement (cup retention, smaller internal diameter CLs, signs of probable impingement from the femoral side) was associated with higher rates of constraint-related complications. The presence of factors related to soft-tissue stabilisers did not increase the rate of complications. The simultaneous presence of multiple impingement-related risk factors resulted in worse outcomes.</p><p><strong>Conclusions: </strong>CLs may be less effective for treating or preventing instability related to impingement. CLs should be used with caution or avoided when multiple impingement-related risk factors are present.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and complications of a non-modular dual-mobility acetabular device, minimum 2 years follow-up.","authors":"Julia E Todderud, Lauren Holbrook, David F Scott","doi":"10.1177/11207000241283775","DOIUrl":"https://doi.org/10.1177/11207000241283775","url":null,"abstract":"<p><strong>Introduction: </strong>Non-modular dual-mobility (DM) acetabular bearing constructs are becoming more popular due to their potential advantages for addressing range of motion (ROM) and stability. The objective of this post-market clinical study was to assess clinical outcomes, including patient satisfaction, pain and function, survivorship, and component positioning, in patients ⩾2 years after primary THA using non-modular DM acetabular components.</p><p><strong>Methods: </strong>This retrospective, multicentre study evaluated complications and functional outcomes in recipients of non-modular DM acetabular constructs at least 2 years post-THA. Our primary outcomes included the dislocation rate and mean Hip disability and Osteoarthritis Outcomes Score (HOOS). Secondary outcomes included radiographic measurements, patient satisfaction, Forgotten Joint Score (FJS), Harris Hip Score (HHS), and survivorship.</p><p><strong>Results: </strong>316 eligible patients enrolled in this study across 3 sites, including 168 men (53%) and 148 women (47%). The cohort averaged 5.37 years post-THA (range 2.2-10.1 years) at the study visit. The mean FJS, HHS, and HOOS were good to excellent, with values of 82.3, 90.7, and 92.0, respectively. Patient satisfaction averaged 4.68, between \"Very Good\" (4) and \"Excellent\" (5). Minimal radiolucent lines (RLL) surrounded the acetabulum. More RLL surrounded the femur, but most lines were less than 1 mm (4.7% of the study population). There were few adverse events (4 events, 1.3%). Three revisions were performed (0.9%), with one patient requiring removal of the acetabular cup.</p><p><strong>Discussion: </strong>The high mid- to long-term survivorship and low to no dislocation and reoperation rates indicate this acetabular DM device is a viable option for THA patients. The patient metrics reflect satisfaction, alleviated pain, and restored function with a low risk of adverse outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The push-through total femoral prosthesis for revision of a total hip or knee replacement with extreme bone loss.","authors":"Sancar Bakircioglu, Abdulkadir M Bulut, Melih Oral, Omur Çağlar, Bulent Atilla, A Mazhar Tokgözoğlu","doi":"10.1177/11207000241282111","DOIUrl":"https://doi.org/10.1177/11207000241282111","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study was to assess outcomes of using the push-through total femoral prothesis (PTTF) for revision total hip replacement with extreme bone loss.</p><p><strong>Methods: </strong>10 consecutive patients who received PTTF between 2012 and 2018 for revision hip arthroplasty were included in the study. Primary functional outcomes were assessed using Harris Hip Score (HHS), Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) scores. Range of motion, complications, and ambulatory status were also recorded to assess secondary outcomes.</p><p><strong>Results: </strong>2 of 10 patients underwent surgery with PTTF for both knee and hip arthroplasty revision. The mean time between index surgery and PTTF was 15 years (3-32 yrs). Acetabular components were revised in 6 of 10 patients during PTTF application. After a mean follow-up of 5.9 years, hip dislocations occurred in 3 patients. All of the dislocated hips were ones with retained conventional non-constrained acetabular bearings. Patient satisfaction was high (MSTS: 67%, HHS: 61.2%, TESS 64.6%) despite high re-operation rate (40%) and minor postoperative problems.</p><p><strong>Conclusions: </strong>PTTF should be considered for hip and knee arthroplasty revision procedures in patients with an extreme bone defect. Consistent usage of constrained liners should be considered to avoid hip dislocation, which was our main problem following the procedure.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The L1 spino-pelvic (L1SP) angle: a simplified approach for the assessment of the PI-LL mismatch in hip surgery.","authors":"A Mounir Boudali, Yuan Chai, John E Farey, Jonathan Vigdorchik, William L Walter","doi":"10.1177/11207000241282984","DOIUrl":"https://doi.org/10.1177/11207000241282984","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic incidence - lumbar lordosis (PI-LL) mismatch is often considered when assessing spinopelvic alignment in the sagittal plane. The mismatch is conventionally obtained by measuring 2 separate angles on lateral spinopelvic radiographs. This study describes a simplified approach for assessing spinopelvic mobility and measuring the PI-LL mismatch through the evaluation of the L1-spinopelvis angle (L1SP).</p><p><strong>Methods: </strong>96 standing lateral radiographs were obtained from consecutive patients presenting for total hip arthroplasty between November 2020 and July 2021. 3 operators were recruited to annotate landmarks on digital radiographs. Correlation analysis and error analysis were applied. Measurement reproducibility was assessed using intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>The correlation coefficients of the 3 variables were respectively 0.87 for PI, 0.94 for LL, and 0.96 for L1SP. The normalised root mean square error between the 2 measurement sets was 9.96% for PI, 5.97% for LL, and 4.41% for L1SP. The absolute error was 3.49° ± 4.63° for PI, 3.23° ± 3.78° for LL, 2.68° ± 3.19° for PI-LL conventional, and 2.35° ± 2.88° for PI-LL via L1SP, respectively. In terms of reproducibility, measurement of L1SP outperformed that of PI and LL (ICC = 0.97 versus 0.83 and 0.93, respectively).</p><p><strong>Conclusion: </strong>The simplified L1SP method, through the measurement of a single angle, produced similar measurements to the conventional PI-LL method. The measurement repeatability between operators was improved using the L1SP method. From a clinical practice perspective, both methods are equivalent. The new method is readily reproducible using commercially available PACS software during preoperative templating.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision rates of one new and two established hemiarthroplasty heads: a comparative cohort study from the Swedish Arthroplasty Register.","authors":"Cecilia Rogmark, Jonatan Nåtman, Sören Overgaard, Maziar Mohaddes","doi":"10.1177/11207000241282081","DOIUrl":"https://doi.org/10.1177/11207000241282081","url":null,"abstract":"<p><strong>Introduction: </strong>The anatomical Lubinus SPII-stem is commonly used in hemi-arthroplasty for femoral neck fractures (FNF), combined with either the bipolar Variocup, the Unipolar Head (UH) and a newly introduced unipolar Modular Trauma Head (MTH). Similar constructs like the MTH are reported to have risk of corrosion and wear. This is the first publication evaluating the MTH.</p><p><strong>Aim: </strong>To describe the revision rate of the SPII-stems/heads which were divided into 3 groups (Variocup, UH, MTH). The head types are compared by their rate of revision at 2 years, due to any cause and to dislocation. Revision and mortality rates up to 10 years are reported.</p><p><strong>Methods: </strong>This observational cohort study based on prospectively registered data from the Swedish Arthroplasty Register included 33,059 patients with hemiarthroplasty 2005-2021 due to FNF. SPII-stems combined with Variocup (<i>n =</i> 7,281), UH (<i>n =</i> 23,980), MTH (<i>n =</i> 1,798) were included. The follow-up ended at 10 years for Variocup and UH, for MTH at 2 years. Kaplan-Meier survival analyses was used, with a 95% confidence interval (CI). Patients were censored at death or at the end of the study (31 December 2021).</p><p><strong>Results: </strong>The 2-year revision rate regardless of cause was similar between the groups: after Variocup 3.5% (CI, 3.1-4.0), UH 3.1% (CI, 2.9-3.4), MTH 3.5% (CI, 2.6-4.5).At 10 years, the Variocup and UH had similar revision rates; 4.6% (CI, 4.0-5.2) and 5.0% (CI, 4.4-5.6).For revision due to dislocation at 2 years Variocup 2.3% (CI, 1.9-2.7) had an inferior outcome compared to UH 1.5% (CI, 1.3-1.7). The MTH had an intermediate outcome, 1.7% (CI, 1.0-2.3). Variocup had a higher dislocation related revision rate, until the 10th year.The 2-year-mortality was 36% (CI, 35-37) after Variocup, 43% (CI, 42-43) after UH and 44% (CI, 41-47) after MTH.</p><p><strong>Conclusions: </strong>The hemi-heads have comparable revision rates within 2 and 10 years. The new MTH performs similar to the standard UH. The bipolar Variocup is associated with more revisions due to dislocation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"6-year follow-up on migration outcomes: a randomised clinical trial of cemented vitamin E-stabilised highly crosslinked versus standard polyethylene cup in total hip arthroplasty","authors":"Olof Sköldenberg, Sebastian Mukka, Martin Magneli","doi":"10.1177/11207000241267971","DOIUrl":"https://doi.org/10.1177/11207000241267971","url":null,"abstract":"Background:In a previous study we have shown that a cemented vitamin E-doped highly cross-linked polyethylene (VEPE) compared to a conventional polyethylene cup in total hip arthroplasty (THA) has a slightly higher proximal migration but significantly lower wear rates up to 2 years after surgery. In this follow-up study we investigated the same cohort at 6 years.Methods:This was a double-blinded, non-inferiority, randomised controlled trial on patients with osteoarthritis, with a mean age of 66 years. Patients were randomly assigned to receive either the conventional polyethylene cup or the VEPE cup in a 1:1 ratio. The primary endpoint was proximal implant migration of the cup measured with radiostereometric analysis (RSA). Secondary endpoints included wear rate of the cup and patient-reported outcome measurements (PROM).Results:At the 6-year follow-up, 25 patients (11 controls, 14 VEPE) were available for RSA measurements, and we found no statistically significant difference in proximal migration between the VEPE and control groups. The wear rate was significantly lower in the VEPE group compared to controls, 0.03 mm/year and 0.07 mm/year, respectively with a mean difference 0.04 mm, (95% CI, 0.02–0.06 mm). There were no cup revisions and no difference in PROM between the groups.Conclusions:Based on our 6-year results, the VEPE group exhibited no statistical or clinically relevant difference compared to the control group, and the wear rate was significantly lower in the VEPE group. The use of a cemented vitamin E-doped highly cross-linked cup is a good option in total hip arthroplasty.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of acetabular impaction grafting with cemented cups and trabecular metal for revision hip arthroplasty: a follow-up study","authors":"Mark Curtin, Shane P Russell, Rayyan S Mirdad, Shane C Irwin, Fiachra E Rowan, Eric L Masterson, Finbarr Condon","doi":"10.1177/11207000241266939","DOIUrl":"https://doi.org/10.1177/11207000241266939","url":null,"abstract":"Introduction:Revision hip arthroplasty in the presence of complex acetabular deficiencies is challenging. Cement, allograft, reconstruction rings and porous trabecular metal now provide versatile options for acetabular fixation and restoration of acetabular offset. We compare acetabular impaction bone grafting (AIBG) and trabecular metal (TM) cups at long-term follow-up.Methods:53 patients who underwent revision hip arthroplasty were retrospectively reviewed from local joint registry data. 36 patients were revised using AIBG and 17 with TM. Median clinical follow-up was 9.57 (2.46–18.72) years and 9.65 (7.22–12.46) years, respectively. 82% of the TM group and 63% of the AIBG group were ⩾ Paprosky 2C. Re-revision was considered failure. Radiographs demonstrating 5 mm of femoral head migration and 5° of acetabular component inclination change were considered loose.Results:Patients receiving AIBG were younger (68 vs. 74 years) with a longer interval from initial arthroplasty to revision (17 vs. 13 years). Revisions in both groups were indicated most commonly for failed cementing (AIBG 88.9% vs. TM 70.5%). No TM reconstructions underwent re-revision, with only 1 failing at 6.3 years, compared with 9 AIBG re-revisions. When revising for sepsis, 33% of AIBG revisions failed.Conclusions:AIBG demonstrated high failure rates at long-term follow-up when compared to TM constructs. We recommend the use of AIBG in small cavitary defects only. We strongly advise against its use in the setting of significant bony defects and for prosthetic joint infection.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}