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Systematic review on outcomes of acetabular revisions with highly-porous metals

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Abstract

Purpose

The purpose of this study was to systematically review the literature and report the clinical and radiographic outcomes of highly-porous acetabular cups in revision settings.

Method

A literature search of four electronic databases of EMBASE, CINAHL-plus, PubMed, and SCOPUS yielded 25 studies reporting the outcomes of 2,083 revision procedures with highly-porous acetabular components. There was lack of high quality evidence (level I and level II studies) and only two studies with level III evidence, while the remainder were all level IV studies. In addition, a majority of the studies had small sample sizes and had short to mid-term follow-up. The mean age of the patients was 65 years (range, 58–72 years) and the mean follow-up was 3.6 years (range, two to six years). Outcomes evaluated were aseptic survivorship, Harris hip scores, migration rates, incidence of peri-acetabular radiolucencies and radiographic restoration of the hip centre.

Results

The mean aseptic survivorship was 97.2 % (range, 80–100 %). The Harris hip scores improved from a mean pre-operative score of 42 points, (range, 29–75 points), to a mean postoperative score of 79 points (range, 69–94 points). The mean incidence of cup migration and prevalence of peri-acetabular radiolucencies was 2.4 % (range, 0–8.8 %) and 4.6 % (range, 0–19 %), respectively, at final follow-up. The vertical hip centre-of-rotation was restored significantly from a mean of 39.2 mm (range, 27.6–50 mm) pre-operatively, to a mean of 24.1 mm (range, 7.4–47 mm), postoperatively.

Conclusion

The short-term clinical and radiographic results of highly-porous metals in revision hip arthroplasty are excellent with a low rate of loosening in the presence of both major and minor bone loss.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA

    Samik Banerjee, Kimona Issa, Bhaveen H. Kapadia, Robert Pivec & Harpal S. Khanuja

  2. Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, MD, USA

    Michael A. Mont

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  1. Samik Banerjee
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  2. Kimona Issa
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Correspondence to Michael A. Mont.

Appendix

Appendix

Table 6 presents the pre-operative diagnosis prior to acetabular revision, and Table 7 shows the distribution of acetabular defects based on Paprosky’s classification.

Table 6 Pre-operative diagnosis prior to acetabular revision
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Table 7 Distribution of acetabular defects based on Paprosky’s classification
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Banerjee, S., Issa, K., Kapadia, B.H. et al. Systematic review on outcomes of acetabular revisions with highly-porous metals. International Orthopaedics (SICOT) 38, 689–702 (2014). https://doi.org/10.1007/s00264-013-2145-5

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