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Clinical Orthopaedics and Related Research

, Volume 467, Issue 1, pp 199–205 | Cite as

Modular Tantalum Augments for Acetabular Defects in Revision Hip Arthroplasty

  • Alexander Siegmeth
  • Clive P. Duncan
  • Bassam A. Masri
  • Winston Y. Kim
  • Donald S. GarbuzEmail author
Symposium: Papers Presented at the Hip Society Meetings 2008

Abstract

Large acetabular defects can be reconstructed with various methods depending on size and location of the defect. We prospectively followed our first 37 patients in whom we reconstructed the acetabulum with a trabecular metal augment combined with a trabecular metal shell. Three patients died before completing the minimum 24 months followup while the remaining 34 were followed a minimum of 24 months (mean, 34 months; range, 24–55 months). All defects were classified according to Paprosky. Radiographic signs of osseointegration were classified according to Moore. Quality of life was measured with the SF-12, WOMAC, and Oxford Hip Score. There were 15 men and 19 women with an average age of 64 years. At a minimum of two years followup 32 of the 34 patients required no further surgery for aseptic loosening, while two had rerevision. Of the 32 patients who had not been revised, all had stable cups radiographically. All quality-of-life parameters improved. The early results with tantalum augments are promising but longer followup is required.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Keywords

Trabecular Metal Acetabular Defect Acetabular Reconstruction Structural Allograft Acetabular Shell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMedGoogle Scholar
  2. 2.
    Black J. Biological performance of tantalum. Clin Mater. 1994;16:167–173.PubMedCrossRefGoogle Scholar
  3. 3.
    Bobyn JD, Poggie RA, Krygier JJ, Lewallen DG, Hanssen AD, Lewis RJ, Unger AS, O’Keefe, TJ, Christie MJ, Nasser S, Wood JE, Stulberg SD, Tanzer M. Clinical validation of a structural porous tantalum biomaterial for adult reconstruction. J Bone Joint Surg Am. 2004;86(Suppl 2):123–129.Google Scholar
  4. 4.
    Chen WM, Engh CA Jr, Hopper RH Jr, McAuley JP, Engh CA. Acetabular revision with use of a bilobed component inserted without cement in patients who have acetabular bone-stock deficiency. J Bone Joint Surg Am. 2000;82:197–206.PubMedGoogle Scholar
  5. 5.
    Christie MJ. Clinical applications of trabecular metal. Am J Orthop. 2002;31:219–220.PubMedGoogle Scholar
  6. 6.
    Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996;78:185–190.PubMedGoogle Scholar
  7. 7.
    Dearborn JT, Harris WH. 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. 1999;81:469–480.PubMedGoogle Scholar
  8. 8.
    Dearborn JT, Harris WH. Acetabular revision arthroplasty using so-called jumbo cementless components: an average 7-year follow-up study. J Arthroplasty. 2000;15:8–15.PubMedCrossRefGoogle Scholar
  9. 9.
    Dewal H, Chen F, Su E, Di Cesare PE. Use of structural bone graft with cementless acetabular cups in total hip arthroplasty. J Arthroplasty. 2003;18:23–28.PubMedCrossRefGoogle Scholar
  10. 10.
    Garbuz D. Revision total hip: a novel modular cementless acetabular system for reconstruction of severe acetabular bone loss. Operative Techniques in Orthopaedics. 2004;14:117–120.CrossRefGoogle Scholar
  11. 11.
    Goodman S, Saastamoinen H, Shasha N, Gross A. Complications of ilioischial reconstruction rings in revision total hip arthroplasty. J Arthroplasty. 2004;19:436–446.PubMedCrossRefGoogle Scholar
  12. 12.
    Gross AE. Revision arthroplasty of the acetabulum with restoration of bone stock. Clin Orthop Relat Res. 1999;369:198–207.PubMedCrossRefGoogle Scholar
  13. 13.
    Gross AE, Goodman S. The role of cages and rings: when all else fails. Orthopedics. 2004;27:969–970.PubMedGoogle Scholar
  14. 14.
    Gross AE, Goodman S. The current role of structural grafts and cages in revision arthroplasty of the hip. Clin Orthop Relat Res. 2004;429:193–200.PubMedCrossRefGoogle Scholar
  15. 15.
    Moore MS, McAuley JP, Young AM, Engh CA Sr. Radiographic signs of osseointegration in porous-coated acetabular components. Clin Orthop Relat Res. 2006;444:176–183.PubMedCrossRefGoogle Scholar
  16. 16.
    Nehme A, Lewallen DG, Hanssen AD. Modular porous metal augments for treatment of severe acetabular bone loss during revision hip arthroplasty. Clin Orthop Relat Res. 2004;429:201–208.PubMedCrossRefGoogle Scholar
  17. 17.
    Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994;9:33–44.Google Scholar
  18. 18.
    Schreurs BW, Bolder SB, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP. Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up. J Bone Joint Surg Br. 2004;86:492–497.PubMedGoogle Scholar
  19. 19.
    Shinar AA, Harris WH. Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg Am. 1997;79:159–168.PubMedGoogle Scholar
  20. 20.
    Sporer SM, Paprosky WG. The use of a trabecular metal acetabular component and trabecular metal augment for severe acetabular defects. J Arthroplasty. 2006;21:83–86.PubMedCrossRefGoogle Scholar
  21. 21.
    Templeton JE, Callaghan, JJ, Goetz DD, Sullivan PM, Johnston RC. Revision of a cemented acetabular component to a cementless acetabular component. A ten to fourteen-year follow-up study. J Bone Joint Surg Am. 2001;83:1706–1711.PubMedGoogle Scholar
  22. 22.
    Unger AS, Lewis RJ, Gruen T. Evaluation of a porous tantalum uncemented acetabular cup in revision total hip arthroplasty: clinical and radiological results of 60 hips. J Arthroplasty. 2005;20:1002–1009.PubMedCrossRefGoogle Scholar
  23. 23.
    Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRefGoogle Scholar
  24. 24.
    Whaley AL, Berry DJ, Harmsen WS. Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty. J Bone Joint Surg Am. 2001;83:1352–1357.PubMedGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Alexander Siegmeth
    • 1
  • Clive P. Duncan
    • 2
  • Bassam A. Masri
    • 2
  • Winston Y. Kim
    • 3
  • Donald S. Garbuz
    • 2
    Email author
  1. 1.Department of OrthopaedicsGolden Jubilee National HospitalGlasgowUK
  2. 2.Division of Lower Limb Reconstruction and Oncology, Department of OrthopaedicsUniversity of British ColumbiaRoom 3114, 910 West 10th AvenueVancouverCanadaV5Z 4E3
  3. 3.Department of OrthopaedicsHope HospitalManchesterUK

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