Acetabular Revision Using Trabecular Metal Augments for Paprosky Type 3 Defects

J Arthroplasty. 2018 Mar;33(3):823-828. doi: 10.1016/j.arth.2017.10.031. Epub 2017 Dec 6.

Abstract

Background: Trabecular Metal (TM) augments are one option when reconstructing bone loss during acetabular side revision surgery.

Methods: We studied 38 consecutive patients with Paprosky type 3 defects that were revised using a TM shell and one or more augments over a 6-year period. There were 29 Paprosky type 3A defects and 9 Paprosky type 3B defects. The mean age of the patients at the time of surgery was 68.2 years (range 48-84). The mean length of follow-up was 36 months (range 18-74).

Results: The mean preoperative short form 12 health survey improved from 27.7 before operation to 30.1 at the time of final follow-up (P = .001). The mean Western Ontario and McMaster Universities Osteoarthritis Index score improved from 53 preoperatively to a mean of 78.8 at final follow-up (P < .0001). There was evidence of radiographic loosening in 7 of the cup-augment constructs. One patient developed a deep infection requiring re-revision. Two patients required revision for aseptic loosening.

Conclusion: The use of TM in complex acetabular reconstruction is associated with good outcome in the short to medium term.

Keywords: arthroplasty; augments; hip; metal; revision; trabecular.

MeSH terms

  • Acetabulum / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Arthroplasty, Replacement, Hip / methods*
  • Bone Screws
  • Cancellous Bone
  • Female
  • Health Surveys
  • Hip Prosthesis*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Metals
  • Middle Aged
  • Osteoarthritis / surgery
  • Preoperative Period
  • Prosthesis Failure
  • Reoperation / instrumentation*
  • Reoperation / methods*
  • Retrospective Studies
  • Severity of Illness Index
  • Skin

Substances

  • Metals