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Erschienen in: Archives of Orthopaedic and Trauma Surgery 4/2011

01.04.2011 | Orthopaedic Surgery

Should the well-fixed, uncemented femoral components be revised during isolated acetabular revision?

verfasst von: Kiyokazu Fukui, Ayumi Kaneuji, Tanzo Sugimori, Toru Ichiseki, Kenji Kitamura, Tadami Matsumoto

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 4/2011

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Abstract

Introduction

The results of isolated acetabular revision performed in 35 patients (36 hips) were monitored from 3 to 10 years. All femoral components were well fixed and not removed or revised during index surgery.

Method

All revision acetabular implants were cementless, using a porous-coated hemispheric cup with or without bone graft. There were no cases of femoral component radiographic or clinical failure. For some cases, we performed bone grafting to focal osteolysis of the proximal femur around the cementless stem.

Results

Bone incorporation occurred in 12 hips (overall 14). The mean pre- and postoperative Harris Hip Scores were 49 and 80, respectively. The findings suggest that isolated acetabular revision using a cementless porous-coated hemispheric cup can be performed without removing or revising a stable, well-fixed, uncemented femoral component if there is no concern about dislocation.

Conclusion

We demonstrated that isolated acetabular revision is feasible and that grafting to the osteolytic femoral defects is a worthwhile procedure to restore bone stock.
Literatur
1.
Zurück zum Zitat Harris WH (1996) Modularity is unnecessary in primary femoral THA but has some advantages in primary acetabular THA. J Arthroplasty 11:334–336PubMedCrossRef Harris WH (1996) Modularity is unnecessary in primary femoral THA but has some advantages in primary acetabular THA. J Arthroplasty 11:334–336PubMedCrossRef
2.
Zurück zum Zitat Barrack RL, Folgueras AJ (1995) Revision total hip arthroplasty: the femoral component. J Am Acad Orthop Surg 3:79PubMed Barrack RL, Folgueras AJ (1995) Revision total hip arthroplasty: the femoral component. J Am Acad Orthop Surg 3:79PubMed
3.
Zurück zum Zitat Silverton CD, Rosenberg AG, Sheinkop MB et al (1995) Revision total hip arthroplasty using a cementless acetabular component: technique and results. Clin Orthop 319:201PubMed Silverton CD, Rosenberg AG, Sheinkop MB et al (1995) Revision total hip arthroplasty using a cementless acetabular component: technique and results. Clin Orthop 319:201PubMed
4.
Zurück zum Zitat Nabors ED, Liebelt R, Mattingly DA, Bierbaum BE (1996) Removal and reinsertion of cemented femoral components during acetabular revision. J Arthroplasty 11(2):146–152PubMedCrossRef Nabors ED, Liebelt R, Mattingly DA, Bierbaum BE (1996) Removal and reinsertion of cemented femoral components during acetabular revision. J Arthroplasty 11(2):146–152PubMedCrossRef
5.
Zurück zum Zitat Heekin RD, Engh CA, Vinh T (1995) Morselized allograft in acetabular reconstruction: a postmortem retrieval analysis. Clin Orthop 319:184PubMed Heekin RD, Engh CA, Vinh T (1995) Morselized allograft in acetabular reconstruction: a postmortem retrieval analysis. Clin Orthop 319:184PubMed
6.
Zurück zum Zitat Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr (1973) Ectopic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg Am 55:1629–1632PubMed Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr (1973) Ectopic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg Am 55:1629–1632PubMed
7.
Zurück zum Zitat Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop 257:107–128PubMed Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop 257:107–128PubMed
8.
Zurück zum Zitat Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop Relat Res 231:7–28PubMed Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop Relat Res 231:7–28PubMed
9.
Zurück zum Zitat Massin P, Schmidt L, Engh CA (1989) Evaluation of cementless acetabular component migration: an experimental study. J Arthroplasty 4:245–251PubMedCrossRef Massin P, Schmidt L, Engh CA (1989) Evaluation of cementless acetabular component migration: an experimental study. J Arthroplasty 4:245–251PubMedCrossRef
10.
Zurück zum Zitat Zicat B, Engh CA, Gokcen E (1995) Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg Am 77:432–439PubMed Zicat B, Engh CA, Gokcen E (1995) Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg Am 77:432–439PubMed
11.
Zurück zum Zitat Delee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32PubMed Delee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32PubMed
12.
Zurück zum Zitat Wasielewski RC, Cooperstein LA, Kruger MP, Rubash HE (1990) Acetabular anatomy and the transacetabular fixation of screws in total hip arthroplasty. J Bone Joint Surg Am 72:501PubMed Wasielewski RC, Cooperstein LA, Kruger MP, Rubash HE (1990) Acetabular anatomy and the transacetabular fixation of screws in total hip arthroplasty. J Bone Joint Surg Am 72:501PubMed
13.
Zurück zum Zitat Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed
14.
Zurück zum Zitat D’Antonio JA, Capello WN, Borden LS et al (1989) Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop 243:126PubMed D’Antonio JA, Capello WN, Borden LS et al (1989) Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop 243:126PubMed
15.
Zurück zum Zitat Jasty M, Harris WH (1990) Salvage total hip reconstruction in patients with major acetabular bone deficiency using structural femoral head allografts. J Bone Joint Surg Br 72:63–67PubMed Jasty M, Harris WH (1990) Salvage total hip reconstruction in patients with major acetabular bone deficiency using structural femoral head allografts. J Bone Joint Surg Br 72:63–67PubMed
16.
Zurück zum Zitat Moskal JT, Shen FH, Brown TE (2002) The fate of stable femoral components retained during isolated acetabular revision: a six-to-twelve-year follow-up study. J Bone Joint Surg Am 84:250–255PubMed Moskal JT, Shen FH, Brown TE (2002) The fate of stable femoral components retained during isolated acetabular revision: a six-to-twelve-year follow-up study. J Bone Joint Surg Am 84:250–255PubMed
17.
Zurück zum Zitat Schmalzried TP, Jasty M, Harris WH (1992) Periprosthetic bone loss in total hip arthroplasty: polyethylene wear debris and the concept of the effective joint space. J Bone Joint Surg Am 74:849–863PubMed Schmalzried TP, Jasty M, Harris WH (1992) Periprosthetic bone loss in total hip arthroplasty: polyethylene wear debris and the concept of the effective joint space. J Bone Joint Surg Am 74:849–863PubMed
18.
Zurück zum Zitat Wan Z, Dorr LD (1996) Natural history of femoral focal osteolysis with proximal ingrowth smooth stem implant. J Arthroplasty 11:718–725PubMedCrossRef Wan Z, Dorr LD (1996) Natural history of femoral focal osteolysis with proximal ingrowth smooth stem implant. J Arthroplasty 11:718–725PubMedCrossRef
19.
Zurück zum Zitat Willert HG, Bertram H, Buchhorn GH (1990) Osteolysis in alloarthroplasty of the hip: the role of ultra-high molecular weight polyethylene wear particles. Clin Orthop Relat Res 258:95–107PubMed Willert HG, Bertram H, Buchhorn GH (1990) Osteolysis in alloarthroplasty of the hip: the role of ultra-high molecular weight polyethylene wear particles. Clin Orthop Relat Res 258:95–107PubMed
20.
Zurück zum Zitat Jasty M, Bragdon C, Jiranek W, Chandler H, Maloney W, Harris WH (1994) Etiology of osteolysis around porous-coated cementless total hip arthroplasties. Clin Orthop Relat Res 308:111–126PubMed Jasty M, Bragdon C, Jiranek W, Chandler H, Maloney W, Harris WH (1994) Etiology of osteolysis around porous-coated cementless total hip arthroplasties. Clin Orthop Relat Res 308:111–126PubMed
21.
Zurück zum Zitat Dorr LD, Wan Z, Shahrdar C, Sirianni L, Boutary M, Yun A (2005) Clinical performance of a Durasul highly cross-linked polyethylene acetabular liner for total hip arthroplasty at five years. J Bone Joint Surg Am 87:1816–1821PubMedCrossRef Dorr LD, Wan Z, Shahrdar C, Sirianni L, Boutary M, Yun A (2005) Clinical performance of a Durasul highly cross-linked polyethylene acetabular liner for total hip arthroplasty at five years. J Bone Joint Surg Am 87:1816–1821PubMedCrossRef
22.
Zurück zum Zitat Muratoglu OK, Bragdon CR, O’Connor DO, Jasty M, Harris WH (2001) A novel method of cross-linking ultra-high-molecular-weight polyethylene to improve wear, reduce oxidation, and retain mechanical properties. Recipient of the 1999 HAP Paul Award. J Arthroplasty 16:149–160PubMedCrossRef Muratoglu OK, Bragdon CR, O’Connor DO, Jasty M, Harris WH (2001) A novel method of cross-linking ultra-high-molecular-weight polyethylene to improve wear, reduce oxidation, and retain mechanical properties. Recipient of the 1999 HAP Paul Award. J Arthroplasty 16:149–160PubMedCrossRef
23.
Zurück zum Zitat Hozack WJ, Bicalho PS, Eng K (1996) Treatment of femoral osteolysis with cementless total hip revision. J Arthroplasty 11:668–672PubMedCrossRef Hozack WJ, Bicalho PS, Eng K (1996) Treatment of femoral osteolysis with cementless total hip revision. J Arthroplasty 11:668–672PubMedCrossRef
24.
Zurück zum Zitat Min BW, Song KS, Cho CH, Bae KC, Lee KJ (2009) Femoral osteolysis around the unrevised stem during isolated acetabular revision. Clin Orthop Relat Res 467:1501–1506PubMedCrossRef Min BW, Song KS, Cho CH, Bae KC, Lee KJ (2009) Femoral osteolysis around the unrevised stem during isolated acetabular revision. Clin Orthop Relat Res 467:1501–1506PubMedCrossRef
25.
Zurück zum Zitat Christiansen CM, Seger BM, Schultz RB (1989) Management of intraoperative femur fractures associated with revision hip arthroplasty. Clin Orthop 248:177–180 Christiansen CM, Seger BM, Schultz RB (1989) Management of intraoperative femur fractures associated with revision hip arthroplasty. Clin Orthop 248:177–180
26.
Zurück zum Zitat Turner RH, Mattingly DA, Scheller A (1987) Femoral revision arthroplasty using a long-stem femoral component: clinical and radiographic analysis. J Arthroplasty 2:247–258PubMedCrossRef Turner RH, Mattingly DA, Scheller A (1987) Femoral revision arthroplasty using a long-stem femoral component: clinical and radiographic analysis. J Arthroplasty 2:247–258PubMedCrossRef
27.
Zurück zum Zitat Amstutz HC, Ma SM, Jinnah RH, Mal L (1982) Revision of aseptic loose total hip arthroplasties. Clin Orthop 170:21–33PubMed Amstutz HC, Ma SM, Jinnah RH, Mal L (1982) Revision of aseptic loose total hip arthroplasties. Clin Orthop 170:21–33PubMed
28.
Zurück zum Zitat Hunter GA, Welsh RE, Cameron HU, Bailey WH (1979) The results of revision of total hip arthroplasty. J Bone Joint Surg Br 61:419–421PubMed Hunter GA, Welsh RE, Cameron HU, Bailey WH (1979) The results of revision of total hip arthroplasty. J Bone Joint Surg Br 61:419–421PubMed
29.
Zurück zum Zitat Callaghan JJ, Salvati EA, Pellici PM et al (1985) Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982: a two to five year follow-up. J Bone Joint Surg Am 67:1074–1085PubMed Callaghan JJ, Salvati EA, Pellici PM et al (1985) Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982: a two to five year follow-up. J Bone Joint Surg Am 67:1074–1085PubMed
30.
Zurück zum Zitat Morsi E, Garbuz D, Gross AE (1996) Revision total hip arthroplasty with shelf bulk allografts: a long term follow-up study. J Arthroplasty 11:86PubMedCrossRef Morsi E, Garbuz D, Gross AE (1996) Revision total hip arthroplasty with shelf bulk allografts: a long term follow-up study. J Arthroplasty 11:86PubMedCrossRef
31.
Zurück zum Zitat Garbuz D, Morsi E, Gross AE (1996) Revision of the acetabular component of a total hip arthroplasty with a massive structural allograft: study with a minimum five-year follow-up. J Bone Joint Surg Am 78:693PubMed Garbuz D, Morsi E, Gross AE (1996) Revision of the acetabular component of a total hip arthroplasty with a massive structural allograft: study with a minimum five-year follow-up. J Bone Joint Surg Am 78:693PubMed
32.
Zurück zum Zitat Dorr LD, Wan Z (1995) Ten years of experience with porous acetabular components for revision surgery. Clin Orthop 319:191PubMed Dorr LD, Wan Z (1995) Ten years of experience with porous acetabular components for revision surgery. Clin Orthop 319:191PubMed
33.
Zurück zum Zitat Paprosky WG, Magnus RE (1994) Principles of bone grafting in revision total hip arthroplasty: acetabular technique. Clin Orthop 298:147PubMed Paprosky WG, Magnus RE (1994) Principles of bone grafting in revision total hip arthroplasty: acetabular technique. Clin Orthop 298:147PubMed
Metadaten
Titel
Should the well-fixed, uncemented femoral components be revised during isolated acetabular revision?
verfasst von
Kiyokazu Fukui
Ayumi Kaneuji
Tanzo Sugimori
Toru Ichiseki
Kenji Kitamura
Tadami Matsumoto
Publikationsdatum
01.04.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 4/2011
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-010-1152-x

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