Partial retention of the acetabular cement mantle in aseptic revision hip arthroplasty: is it a viable option?

Hip Int. 2023 Sep;33(5):899-904. doi: 10.1177/11207000221151199. Epub 2023 Feb 19.

Abstract

Introduction: Choosing the most appropriate reconstruction method when addressing a cemented cup at hip revision surgery can be a difficult decision. The aim of this study is to look into the practice and results of retaining a well-fixed medial acetabular cement mantle while removing loose superolateral cement. This practice goes against a preconceived principle that if some of the cement is loose it must all be removed. So far, no significant series looking at this is available in the literature.

Methods: We assessed a cohort of 27 patients in our institution where this practice was carried out and assessed their outcomes clinically and radiographically.

Results: Of the 27 patients, 24 had follow-up ⩾2 years (2.9-17.8, mean 9.3 years). There was 1 subsequent revision for aseptic loosening at 11.9 years, 1 first-stage revision of both stem and cup for infection at 1 month, and 2 patients died without a 2-year review. 2 patients did not have radiographs available for review. 2 of the 22 patients with radiographs available had changes in lucent lines, which were not clinically significant.

Conclusion: Based on these results we conclude that retaining well-fixed medial cement during socket revision is a viable reconstruction option in carefully selected cases.

Keywords: Acetabulum revision; cement retention; cemented revision; cup revision; hip revision; socket revision.

MeSH terms

  • Acetabulum* / diagnostic imaging
  • Acetabulum* / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects
  • Female
  • Hip Prosthesis
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Failure*
  • Reoperation*