Elsevier

The Journal of Arthroplasty

Volume 25, Issue 6, September 2010, Pages 865-872
The Journal of Arthroplasty

Revision of Failed Total Hip Arthroplasty Acetabular Cups to Porous Tantalum Components: A 5-Year Follow-Up Study

https://doi.org/10.1016/j.arth.2009.07.027Get rights and content

Abstract

We reviewed 263 consecutive patients with failed acetabular components after total hip arthroplasty that were revised using porous tantalum acetabular components and augments when necessary. The mean follow-up was 73.6 months (range, 60-84 months). The improvement of mean Harris hip score, Western Ontario and McMaster Osteoarthritis Index, and University of California Los Angeles activity scales were statistically significant (P < .001). Subjective assessments showed that 87.3% of patients reported “improvement” and 85.9% were “very or fairly pleased” with the results. At the most recent follow-up, all acetabular components were radiographically stable and none required rerevision for loosening. The acetabular revision was considered successful in 87% of cases. From this study, we conclude that the acetabular component used was reliable in creating a durable composite without failure for a minimum of 5 years.

Section snippets

Materials and Methods

Between July 2000 and December 2002, 263 consecutive patients across 5 surgical centers underwent revision of a failed acetabular component in which TM acetabular components were used. Patients presenting with infection, tumors, irradiated pelvis, and patients receiving antitumor drugs were excluded from this series. There were 150 women and 113 men with a mean age of 69.5 years (range, 39-84 years) at the time of revision (Table 1). The mean time from the previous procedure to revision was 8.9

Results

The overall mean follow-up was 73.6 months (range, 60-84 months), and no patient was lost to follow-up. There were 6 deaths unrelated to the revision procedure (2.3%). However, the clinical and radiologic assessments for all 6 patients were collected within the minimum 5-year follow-up period and were subsequently included in this study.

The preoperative HHS rating improved from a mean of 43.6 ± 11.4 (range, 23-62) before revision, to a mean of 82.1 ± 10.7 (range, 48-96) at 1 year after revision

Discussion

Although acetabular revision is a technically demanding operation, our results show that acetabular composite stability and durability can be achieved when using tantalum acetabular components. The rate of success with tantalum components is also similar to that achieved with the custom-made triflange cup [15] and higher than that reached with conventional or extra large cementless cups supplemented by screws, morsellized or structural allografts, and reconstruction rings or cages 17, 18, 47.

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    No benefits or funds were received in support of the study.

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