Periprosthetic acetabular fractures represent a growing and serious complication of total hip arthroplasty (THA). The purpose of the study is to report our experience in the use of tantalum for the treatment of Paprosky type IV and V periprosthetic acetabular fractures.
We analyzed 24 patients with type IV and V periprosthetic acetabular fractures. Patients were treated with a revision surgery using tantalum components, in some cases in association with posterior plating. Outcomes were evaluated using VAS, Harris hip score and considering the average time of integration of the acetabulum and the number of complications. The endpoint evaluation was established at 24 months.
Results show that the average time of integration of the neoacetabulum in tantalum was 12.3 months (range 6–18 months). The average VAS pain is 8.7/10 cm at time 0 and gradually returns to basic pre-injury values in the following months. The average value of HHS at time 0 is 13.5 points. This value tends to increase progressively until reaching a mean score of 89.3 points at 24 months, higher than the average pre-trauma value of 84.3 points.
Periprosthetic fractures of the acetabulum with bone loss are a rare but potentially disastrous complication of total hip prostheses. Their management and therapeutic choice will test the ability of the orthopedic surgeon. It is important to determine the type of fracture and characteristics in order to pursue an adequate therapeutic strategy. The modern biomaterials, such as porous tantalum, offer a greater potential in replacing bone loss, promoting bone regrowth and obtaining a stable implant.
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Conflict of interest
Gabriele Falzarano, Antonio Piscopo, Giuseppe Rollo, Antonio Medici, Predrag Grubor, Michele Bisaccia, Valerio Pipola, Raffaele Cioffi, Francesco Nobile and Luigi Meccariello disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations and grants or other funding.
Human and animal rights
This type of study does not require any statement relating to studies on humans and animals. All patients gave the informed consent prior to being included into the study. All procedures involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments.
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Falzarano, G., Piscopo, A., Rollo, G. et al. Tantalum in type IV and V Paprosky periprosthetic acetabular fractures surgery in Paprosky type IV and V periprosthetic acetabular fractures surgery. Musculoskelet Surg 102, 87–92 (2018). https://doi.org/10.1007/s12306-017-0503-y
- Paprosky acetabular classification
- Bone loss
- Hip revision surgery
- Acetabular periprosthetic fractures