Skip to main content

Bone Loss Around the Acetabular Component

  • Chapter
  • First Online:
  • 769 Accesses

Part of the book series: European Instructional Lectures ((EICL,volume 11))

Abstract

Bone loss around the acetabular component remains one of the most challenging aspects of revision hip surgery. This chapter reviews the aims of the surgeon in treating the loss of pelvic bone stock during revision of the acetabular component, as well as the classification systems that are commonly used to assist with decision-making, both prior to the operation and at the time of the revision. It describes the surgical techniques that are available for acetabular reconstruction and reviews the clinical results that have been published in the literature with these techniques. The emphasis of the chapter is on techniques that specifically address the loss of bone stock surrounding the failed acetabular component.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. D’Antonio JA et al (1989) Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res 243:126–137

    PubMed  Google Scholar 

  2. Paprosky WG, Perona PG, Lawrence JM (1994) Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty 9(1):33–44

    Article  PubMed  CAS  Google Scholar 

  3. Devane PA et al (1997) Measurement of polyethylene wear in acetabular components inserted with and without cement. A randomized trial. J Bone Joint Surg Am 79(5):682–689

    PubMed  CAS  Google Scholar 

  4. McCombe P, Williams SA (2004) A comparison of polyethylene wear rates between cemented and cementless cups. A prospective, randomised trial. J Bone Joint Surg Br 86(3):344–349

    Article  PubMed  CAS  Google Scholar 

  5. Mitchell PA et al (2003) Removal of well-fixed, cementless, acetabular components in revision hip arthroplasty. J Bone Joint Surg Br 85(7):949–952

    Article  PubMed  CAS  Google Scholar 

  6. Rosenberg AG (2003) Cementless acetabular components: the gold standard for socket revision. J Arthroplasty 18(3 Suppl 1):118–120

    Article  PubMed  Google Scholar 

  7. Whaley AL, Berry DJ, Harmsen WS (2001) Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty. J Bone Joint Surg Am 83A(9):1352–1357

    Google Scholar 

  8. Patel JV et al (2003) The fate of cementless jumbo cups in revision hip arthroplasty. J Arthroplasty 18(2):129–133

    Article  PubMed  CAS  Google Scholar 

  9. Jasty M (1998) Jumbo cups and morsalized graft. Orthop Clin North Am 29(2):249–254

    Article  PubMed  CAS  Google Scholar 

  10. Hendricks KJ, Harris WH (2006) Revision of failed acetabular components with use of so-called jumbo noncemented components. A concise follow-up of a previous report. J Bone Joint Surg Am 88(3):559–563

    Article  PubMed  Google Scholar 

  11. Dearborn JT, Harris WH (2000) Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty 15(1):8–15

    Article  PubMed  CAS  Google Scholar 

  12. Obenaus C et al (2003) Extra-large press-fit cups without screws for acetabular revision. J Arthroplasty 18(3):271–277

    Article  PubMed  Google Scholar 

  13. Blackley HR et al (2001) Proximal femoral allografts for reconstruction of bone stock in revision arthroplasty of the hip. A nine to fifteen-year follow-up. J Bone Joint Surg Am 83A(3):346–354

    Google Scholar 

  14. Dewal H et al (2003) Use of structural bone graft with cementless acetabular cups in total hip arthroplasty. J Arthroplasty 18(1):23–28

    Article  PubMed  Google Scholar 

  15. Sporer SM et al (2005) The use of structural distal femoral allografts for acetabular reconstruction. Average ten-year follow-up. J Bone Joint Surg Am 87(4):760–765

    Article  PubMed  Google Scholar 

  16. Chen WM et al (2000) Acetabular revision with use of a bilobed component inserted without cement in patients who have acetabular bone-stock deficiency. J Bone Joint Surg Am 82(2):197–206

    PubMed  CAS  Google Scholar 

  17. Berry DJ et al (2000) Bilobed oblong porous coated acetabular components in revision total hip arthroplasty. Clin Orthop Relat Res 371:154–160

    Article  PubMed  Google Scholar 

  18. Moskal JT, Higgins ME, Shen J (2008) Type III acetabular defect revision with bilobed components: five-year results. Clin Orthop Relat Res 466(3):691–695

    Article  PubMed  Google Scholar 

  19. Dearborn JT, Harris WH (1999) High placement of an acetabular component inserted without cement in a revision total hip arthroplasty. Results after a mean of ten years. J Bone Joint Surg Am 81(4):469–480

    PubMed  CAS  Google Scholar 

  20. Amstutz HC et al (1982) Revision of aseptic loose total hip arthroplasties. Clin Orthop Relat Res 170:21–33

    PubMed  Google Scholar 

  21. Kavanagh BF, Ilstrup DM, Fitzgerald RH Jr (1985) Revision total hip arthroplasty. J Bone Joint Surg Am 67(4):517–526

    PubMed  CAS  Google Scholar 

  22. Callaghan JJ 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(7):1074–1085

    PubMed  CAS  Google Scholar 

  23. Schreurs BW et al (2009) Acetabular revision with impacted morsellised cancellous bone grafting and a cemented acetabular component: a 20- to 25-year follow-up. J Bone Joint Surg Br 91(9):1148–1153

    Article  PubMed  CAS  Google Scholar 

  24. Comba F et al (2006) Acetabular reconstruction with impacted bone allografts and cemented acetabular components: a 2- to 13-year follow-up study of 142 aseptic revisions. J Bone Joint Surg Br 88(7):865–869

    Article  PubMed  CAS  Google Scholar 

  25. Garcia-Cimbrelo E, Cordero J (2002) Impacted morcellised allograft and cemented cup in acetabular revision surgery: a five to nine year follow-up study. Hip Int 12(3):281–288

    Google Scholar 

  26. Rigby M, Whitehouse S, Timperley AJ (2010) Clinical results: acetabular impaction grafting. In: Ling RSM, Gie GA, Timperley AJ, Hubble MJW, Howell JR, Whitehouse SL (eds) The Exeter hip: 40 years of innovation in total hip arthroplasty. Exeter Hip Publishing, Exeter, pp 339–344

    Google Scholar 

  27. van Haaren EH et al (2007) High rate of failure of impaction grafting in large acetabular defects. J Bone Joint Surg Br 89(3):296–300

    Article  PubMed  Google Scholar 

  28. Buttaro MA et al (2008) Acetabular revision with metal mesh, impaction bone grafting, and a cemented cup. Clin Orthop Relat Res 466(10):2482–2490

    Article  PubMed  Google Scholar 

  29. Kawanabe K et al (2007) Revision total hip replacement using the Kerboull acetabular reinforcement device with morsellised or bulk graft: results at a mean follow-up of 8.7 years. J Bone Joint Surg Br 89(1):26–31

    Article  PubMed  CAS  Google Scholar 

  30. Berry DJ, Muller ME (1992) Revision arthroplasty using an anti-protrusio cage for massive acetabular bone deficiency. J Bone Joint Surg Br 74(5):711–715

    PubMed  CAS  Google Scholar 

  31. Carroll FA et al (2008) The survival of support rings in complex acetabular revision surgery. J Bone Joint Surg Br 90(5):574–578

    Article  PubMed  CAS  Google Scholar 

  32. Haddad FS, Shergill N, Muirhead-Allwood SK (1999) Acetabular reconstruction with morcellized allograft and ring support: a medium-term review. J Arthroplasty 14(7):788–795

    Article  PubMed  CAS  Google Scholar 

  33. Wachtl SW et al (2000) The Burch-Schneider antiprotrusio cage in acetabular revision surgery: a mean follow-up of 12 years. J Arthroplasty 15(8):959–963

    Article  PubMed  CAS  Google Scholar 

  34. Regis D et al (2008) Long-term results of anti-protrusion cage and massive allografts for the management of periprosthetic acetabular bone loss. J Arthroplasty 23(6):826–832

    Article  PubMed  Google Scholar 

  35. Black J (1994) Biological performance of tantalum. Clin Mater 16(3):167–173

    Article  PubMed  CAS  Google Scholar 

  36. Weeden SH, Schmidt RH (2007) The use of tantalum porous metal implants for Paprosky 3A and 3B defects. J Arthroplasty 22(6 Suppl 2):151–155

    Article  PubMed  Google Scholar 

  37. Flecher X, Sporer S, Paprosky W (2008) Management of severe bone loss in acetabular revision using a trabecular metal shell. J Arthroplasty 23(7):949–955

    Article  PubMed  Google Scholar 

  38. Van Kleunen JP et al (2009) Acetabular revisions using trabecular metal cups and augments. J Arthroplasty 24z(6 Suppl):64–68

    Article  PubMed  Google Scholar 

  39. Siegmeth A et al (2009) Modular tantalum augments for acetabular defects in revision hip arthroplasty. Clin Orthop Relat Res 467(1):199–205

    Article  PubMed  Google Scholar 

  40. Sporer SM, Paprosky WG (2006) Acetabular revision using a trabecular metal acetabular component for severe acetabular bone loss associated with a pelvic discontinuity. J Arthroplasty 21(6 Suppl 2):87–90

    Article  PubMed  Google Scholar 

  41. Hanssen AD, Lewallen DG (2005) Modular acetabular augments: composite void fillers. Orthopedics 28(9):971–972

    PubMed  Google Scholar 

  42. Goodman S et al (2004) Complications of ilioischial reconstruction rings in revision total hip arthroplasty. J Arthroplasty 19(4):436–446

    Article  PubMed  Google Scholar 

  43. Kosashvili Y et al (2009) Acetabular revision using an anti-protrusion (ilio-ischial) cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity. J Bone Joint Surg Br 91(7):870–876

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan Howell .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 EFORT

About this chapter

Cite this chapter

Howell, J., Bolland, B. (2011). Bone Loss Around the Acetabular Component. In: Bentley, G. (eds) European Instructional Lectures. European Instructional Lectures, vol 11. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18321-8_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18321-8_12

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-18320-1

  • Online ISBN: 978-3-642-18321-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics