The Journal of Bone and Joint Surgery (American). 2006;88:1266-1271.
doi:10.2106/JBJS.E.00540
© 2006 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activity for this article:
 Adult Hip Reconstruction Test 20: Summer 2006 (publication date August 15, ...
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Weeden, S. H.
Right arrow Articles by Paprosky, W. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Weeden, S. H.
Right arrow Articles by Paprosky, W. G.
Related Collections
Right arrow Adult Hip
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Porous-Ingrowth Revision Acetabular Implants Secured with Peripheral Screws

A Minimum Twelve-Year Follow-up

Steven H. Weeden, MD1 and Wayne G. Paprosky, MD2

1 Texas Hip and Knee Center Adult Reconstruction Fellowship Program, 750 Eighth Street, Suite 400, Fort Worth, TX 76104. E-mail address: steveweeden{at}hotmail.com
2 Department of Orthopaedic Surgery, Rush University Medical Center, 25 North Winfield Road, Chicago, IL 60190

Investigation performed at the Rush Medical College and the Central DuPage Hospital Adult Reconstruction Fellowship Program, Chicago, Illinois

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: During revision total hip arthroplasty, the acetabular component is often secured with screws to ensure initial press-fit stability. The purpose of the present study was to assess a series of acetabular revisions involving the use of a porous-coated acetabular component that was stabilized with peripheral screws and to evaluate the results in relation to the acetabular bone deficiencies that were present at the time of the revision procedure.

Methods: From 1987 to 1991, 203 consecutive acetabular revisions were performed. In 142 hips, a severe acetabular bone deficiency that did not require an allograft was reconstructed with a porous-coated acetabular cup that was secured with a minimum of two peripheral screws. After an average duration of follow-up of 13.2 years, 134 hips were reviewed clinically and radiographically. The procedure was considered to be a clinical failure if the component was revised or if the postoperative clinical scores were poorer than the preoperative scores.

Results: At the time of the most recent follow-up, 127 (95%) of the 134 hips were stable and clinically successful. The other seven hips (5%) were considered to have failed. Five of these seven hips failed because of an infection, and two failed because of aseptic loosening. Five (19%) of the twenty-seven hips with a Paprosky type-3A defect (a defect in which 30% to 50% of the host acetabulum is missing) failed.

Conclusions: Revision total hip arthroplasty with use of a porous-coated acetabular component that is fixed with peripheral screws can provide long-term durability in hips with severe acetabular defects that do not require the use of an allograft (Paprosky type-1 and type-2 defects). We recommend that when an acetabular implant with peripheral screws is used for the treatment of a more severe (type-3) defect, the cup should be augmented with structural allograft to improve initial stability, or other implants should be utilized.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
D. K. Park, C. J. Della Valle, L. Quigley, M. Moric, A. G. Rosenberg, and J. O. Galante
Revision of the Acetabular Component without Cement. A Concise Follow-up, at Twenty to Twenty-four Years, of a Previous Report
J. Bone Joint Surg. Am., February 1, 2009; 91(2): 350 - 355.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
W. Maloney and A. Rosenberg
What is the outcome of treatment for osteolysis?
J. Am. Acad. Ortho. Surg., July 1, 2008; 16(suppl_1): S26 - S32.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. H. Huo, N. F. Gilbert, and J. Parvizi
What's New in Total Hip Arthroplasty
J. Bone Joint Surg. Am., August 1, 2007; 89(8): 1874 - 1885.
[Full Text] [PDF]