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Erschienen in: Archives of Orthopaedic and Trauma Surgery 6/2008

01.06.2008 | Orthopaedic Surgery

Jumbo cups for revision of acetabular defects after total hip arthroplasty: a retrospective review of a case series

verfasst von: Christian Wedemeyer, Carl Neuerburg, Hansjoerg Heep, Fabian von Knoch, Marius von Knoch, Franz Löer, Guido Saxler

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 6/2008

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Abstract

The treatment of acetabular bone defects presents a great challenge in revision total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiological outcome of revision THA using jumbo cups for acetabular reconstruction after applying the bone-grafting technique. We studied 17 patients with acetabular defects ranging from Type 2A to Type 3A according to Paprosky`s classification. According to the AAOS-score twelve patients were classified as Type II and five patients as Type III. Uncemented press-fit cups with an outer diameter larger than 64 mm were used in all cases. Fifteen patients received morselized bone allografts. In eight patients an additional screw fixation was necessary. The mean follow-up period was 82 months (range 33–149). The mean Harris Hip Score was preoperatively 62 and at the time of the last follow-up examination 83 points (p = 0.007). Two acetabular components failed, one due to aseptic loosening and another one due to septic loosening. There was a trend of displacement of the femoral head centre towards the infero-lateral position after using jumbo cups that approached statistical significance (p = 0.065). Closure of acetabular defects of Types 2A to 3A according to Paprosky’s classification and type II to III according to the AAOS-score respectively can be satisfactorily accomplished using jumbo cups after applying the bone-grafting technique.
Literatur
1.
Zurück zum Zitat Amstutz HC, Campbell P, Kossovsky N, Clarke IC (1992) Mechanism and clinical significance of wear debris-induced osteolysis. Clin Orthop 276:7–18PubMed Amstutz HC, Campbell P, Kossovsky N, Clarke IC (1992) Mechanism and clinical significance of wear debris-induced osteolysis. Clin Orthop 276:7–18PubMed
2.
Zurück zum Zitat Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95(1–2):47–9PubMedCrossRef Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95(1–2):47–9PubMedCrossRef
3.
Zurück zum Zitat Chandler HP (1995) Structural grafting of acetabulum. Orthopaedics 18:863–864 Chandler HP (1995) Structural grafting of acetabulum. Orthopaedics 18:863–864
4.
Zurück zum Zitat Groß AE (1999) Revision arthroplasty of the acetabulum with restoration of bone stock. Clin Orthop 369:198–207PubMedCrossRef Groß AE (1999) Revision arthroplasty of the acetabulum with restoration of bone stock. Clin Orthop 369:198–207PubMedCrossRef
5.
Zurück zum Zitat Gustke KA (2004) Jumbo cup or high hip center: is bigger better? J Arthroplasty 19(4Suppl 1):120–123PubMedCrossRef Gustke KA (2004) Jumbo cup or high hip center: is bigger better? J Arthroplasty 19(4Suppl 1):120–123PubMedCrossRef
6.
Zurück zum Zitat Hendricks KJ, Harris WH (2006) High placement of noncemented acetabular components in revision total hip arthroplasty. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88(10):2231–2236PubMedCrossRef Hendricks KJ, Harris WH (2006) High placement of noncemented acetabular components in revision total hip arthroplasty. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88(10):2231–2236PubMedCrossRef
7.
Zurück zum Zitat Ito H, Matsuno T, Aoki Y, Minami A (2003) Actabular components without bulk bone graft in revision surgery: a 5– to 13 year follow up study. J Arthroplasty 18(2):134–139PubMedCrossRef Ito H, Matsuno T, Aoki Y, Minami A (2003) Actabular components without bulk bone graft in revision surgery: a 5– to 13 year follow up study. J Arthroplasty 18(2):134–139PubMedCrossRef
9.
Zurück zum Zitat Lachiewicz PF, Hussamy OD (1994) Revision of the acetabulum without cement with use of the Harris-Galante porous-coated implant. Two to eight-year results. J Bone Joint Surg Am 76:1834–1839PubMed Lachiewicz PF, Hussamy OD (1994) Revision of the acetabulum without cement with use of the Harris-Galante porous-coated implant. Two to eight-year results. J Bone Joint Surg Am 76:1834–1839PubMed
10.
Zurück zum Zitat Lachiewicz PF, Poon ED (1998) Revision of a total hip arthroplasty with a Harris-Galante porous-coated acetabular component inserted without cement. A follow-up note on the results at five to twelve years. J Bone Joint Surg Am 80(7):980–984PubMed Lachiewicz PF, Poon ED (1998) Revision of a total hip arthroplasty with a Harris-Galante porous-coated acetabular component inserted without cement. A follow-up note on the results at five to twelve years. J Bone Joint Surg Am 80(7):980–984PubMed
11.
Zurück zum Zitat Moskal JT, Danisa OA, Shaffrey CI (1997) Isolated revision acetabuloplasty using a porous-coated cementless acetabular component without removal of a well-fixed femoral component. A 3- to 9-year follow-up study. J Arthroplasty 12:719–727PubMedCrossRef Moskal JT, Danisa OA, Shaffrey CI (1997) Isolated revision acetabuloplasty using a porous-coated cementless acetabular component without removal of a well-fixed femoral component. A 3- to 9-year follow-up study. J Arthroplasty 12:719–727PubMedCrossRef
12.
Zurück zum Zitat Nieder E, Elson RA, Engelbrecht E, Kasselt MR, Keller A, Steinbrink K (1990) The saddle prosthesis for salvage of the destroyed acetabulum. J Bone Joint Surg 72-B:1014–1022 Nieder E, Elson RA, Engelbrecht E, Kasselt MR, Keller A, Steinbrink K (1990) The saddle prosthesis for salvage of the destroyed acetabulum. J Bone Joint Surg 72-B:1014–1022
13.
Zurück zum Zitat Obenhaus C, Winkle H, Girtler R, Huber M, Schwagerl W (2003) Extra-large press-fit cups without screws for acetabular revision. J Athroplasty 18:271–277CrossRef Obenhaus C, Winkle H, Girtler R, Huber M, Schwagerl W (2003) Extra-large press-fit cups without screws for acetabular revision. J Athroplasty 18:271–277CrossRef
14.
Zurück zum Zitat Paprosky WG, Lawrence J, Cameron H (1990) Acetabular defect classification: clinical application. Orthop Rev 14:3–8 Paprosky WG, Lawrence J, Cameron H (1990) Acetabular defect classification: clinical application. Orthop Rev 14:3–8
15.
Zurück zum Zitat Patel JV, Masonis JL, Bourne RB, Rorabeck CH (2003) The fate of cementless jumbo cups in revision hip arthroplasty. J Arthroplasty 18(2):129–133PubMedCrossRef Patel JV, Masonis JL, Bourne RB, Rorabeck CH (2003) The fate of cementless jumbo cups in revision hip arthroplasty. J Arthroplasty 18(2):129–133PubMedCrossRef
16.
Zurück zum Zitat Perka C, Schneider F, Labs K (2002) Revision acetabular arthroplasty using a pedestal cup in patients with previous congenital dislocation of the hip—four case reports and review of treatment. Arch Orthop Traum Surg 122:237–240CrossRef Perka C, Schneider F, Labs K (2002) Revision acetabular arthroplasty using a pedestal cup in patients with previous congenital dislocation of the hip—four case reports and review of treatment. Arch Orthop Traum Surg 122:237–240CrossRef
17.
Zurück zum Zitat Saleh KJ, Jaroszynski G, Woodgate I, Saleh L, Gross AE (2000) Revision total hip arthroplasty with use of structural acetabular allograft and reconstruction ring: a case series with 10-year average follow-up. J Arthroplasty 15:951–958PubMedCrossRef Saleh KJ, Jaroszynski G, Woodgate I, Saleh L, Gross AE (2000) Revision total hip arthroplasty with use of structural acetabular allograft and reconstruction ring: a case series with 10-year average follow-up. J Arthroplasty 15:951–958PubMedCrossRef
18.
Zurück zum Zitat Saxler G, Fitzek JG, Sterner T, von Knoch M, Barden B, Löer F (2005) Revision of failed acetabular cups with extensive structural allografts. Z Orthop Ihre Grenzgeb 143:56–63PubMedCrossRef Saxler G, Fitzek JG, Sterner T, von Knoch M, Barden B, Löer F (2005) Revision of failed acetabular cups with extensive structural allografts. Z Orthop Ihre Grenzgeb 143:56–63PubMedCrossRef
19.
Zurück zum Zitat Silverton CD, Rosenberg AG, Sheinkop MB, Kull LR, Galante JO (1996) Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years. J Bone Joint Surg Am 78:1366–1370PubMed Silverton CD, Rosenberg AG, Sheinkop MB, Kull LR, Galante JO (1996) Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years. J Bone Joint Surg Am 78:1366–1370PubMed
20.
Zurück zum Zitat Sloof TJ, Buma P, Schreurs BW, Schimmel JW, Huiskes R, Gardeniers J (1996) Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop 324:108–115CrossRef Sloof TJ, Buma P, Schreurs BW, Schimmel JW, Huiskes R, Gardeniers J (1996) Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop 324:108–115CrossRef
21.
Zurück zum Zitat Tanzer M, Drucker D, Jasty M, McDonald M, Harris WH (1992) Revision of the acetabular component with an uncemented Harris-Galante porous-coated prosthesis. J Bone Joint Surg Am 74:987–994PubMed Tanzer M, Drucker D, Jasty M, McDonald M, Harris WH (1992) Revision of the acetabular component with an uncemented Harris-Galante porous-coated prosthesis. J Bone Joint Surg Am 74:987–994PubMed
22.
Zurück zum Zitat Wedemeyer C, Otte S, von Knoch M, Quint U, von Knoch F, Löer F, Saxler G (2007) Structural femoral head allografts in revision surgery of loosened acetabular cups. Unfallchirurg 110(2):104–110PubMedCrossRef Wedemeyer C, Otte S, von Knoch M, Quint U, von Knoch F, Löer F, Saxler G (2007) Structural femoral head allografts in revision surgery of loosened acetabular cups. Unfallchirurg 110(2):104–110PubMedCrossRef
23.
Zurück zum Zitat Whaley AL, Berry DJ, Harmsen WS (2001) Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty. J Bone Joint Surg Am 83:1352–1357PubMed Whaley AL, Berry DJ, Harmsen WS (2001) Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty. J Bone Joint Surg Am 83:1352–1357PubMed
Metadaten
Titel
Jumbo cups for revision of acetabular defects after total hip arthroplasty: a retrospective review of a case series
verfasst von
Christian Wedemeyer
Carl Neuerburg
Hansjoerg Heep
Fabian von Knoch
Marius von Knoch
Franz Löer
Guido Saxler
Publikationsdatum
01.06.2008
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 6/2008
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-007-0501-x

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