Lateral rim mesh in primary total hip arthroplasty: a suitable option to reconstruct segmental acetabular bone defects in young patients?

Bone Joint J. 2019 Jan;101-B(1):96-103. doi: 10.1302/0301-620X.101B1.BJJ-2018-0561.R2.


Aims: The aim of this study was to analyze the effect of a lateral rim mesh on the survival of primary total hip arthroplasty (THA) in young patients, aged 50 years or younger.

Patients and methods: We compared a study group of 235 patients (257 hips) who received a primary THA with the use of impaction bone grafting (IBG) with an additional lateral rim mesh with a group of 306 patients (343 hips) who received IBG in the absence of a lateral rim mesh during the same period from 1988 to 2015. In the mesh group, there were 74 male and 183 female patients, with a mean age of 35 years (13 to 50). In the no-mesh group, there were 173 male and 170 female patients, with a mean age of 38 years (12.6 to 50). Cox regression analyses were performed to study the effect of a lateral rim mesh on acetabular component survival. Kaplan-Meier analyses with 95% confidence intervals (CIs) were performed to estimate the survival of the acetabular implant.

Results: The hazard ratio for the use of lateral rim mesh, adjusted for potential confounders, for acetabular revision for any reason was 0.50 (95% CI 0.13 to 1.93; p = 0.31) and for acetabular revision for aseptic loosening was 0.29 (95% CI 0.020 to 4.04; p = 0.35). The Kaplan-Meier analysis showed a ten-year survival for aseptic loosening of the acetabular of 98% (95% CI 95 to 100, n = 65 at risk) in the mesh group and 94% (89 to 98, n = 76 at risk) in the no-mesh group. The 15-year survival for aseptic acetabular loosening was 90% (81 to 100, n = 35 at risk) in the mesh group and 85% (77 to 94, n = 45 at risk) in the no-mesh group (p = 0.23).

Conclusion: This study shows that the use of a lateral rim mesh in primary THA in young patients is not associated with a higher risk of revision of the acetabular component. Therefore, we consider a lateral rim mesh combined with IBG to be effective in reconstructing segmental acetabular defects in primary THA.

Keywords: Acetabulum; Bone graft; Metal mesh; Total hip arthroplasty; Young patients.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Arthritis, Rheumatoid / surgery
  • Arthroplasty, Replacement, Hip / methods*
  • Bone Transplantation / methods
  • Female
  • Femur Head Necrosis / surgery
  • Hip Dislocation, Congenital / surgery
  • Hip Prosthesis
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / surgery
  • Prosthesis Failure / etiology
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Surgical Mesh*
  • Young Adult