Skip to main content

Implant Selection in Revision Total Hip Arthroplasty

  • Chapter
  • First Online:
Hip Arthroplasty

Abstract

With increasing numbers of primary total hip arthroplasty procedures being performed worldwide, national joint registries are forecasting a potential increase in the number and burden of revision hip arthroplasty numbers in the future. Revision hip arthroplasty can be challenging. Survivorship of the revision procedure is highly dependent on the quality of component fixation achieved with revision components and restoration of hip biomechanics. With advancements in implant design and patient-specific component printing, surgeons have multiple options when performing revision surgery. However, it is paramount that surgeons have guidelines on management of acetabular or femoral bone loss in revision cases to help select the ideal implant to ensure adequate and long-lasting component fixation. This chapter will cover the basics of bone defect classification in the setting of revision total hip arthroplasty, with a brief overview of various reconstruction options with their indications, advantages, and disadvantages. An algorithmic approach to management of bone defects will improve surgeon decision making and outcomes after revision surgery.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
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

Institutional subscriptions

References

  1. Gwam CU, Mistry JB, Mohamed NS, Thomas M, Bigart KC, Mont MA, et al. Current epidemiology of revision total hip arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplast. 2017;32(7):2088–92.

    Article  Google Scholar 

  2. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–5.

    Article  PubMed  Google Scholar 

  3. Mittal G, Kulshrestha V, Kumar S, Datta B. Epidemiology of revision total hip arthroplasty: an Indian experience. Indian J Orthop. 2020;54(5):608–15. https://doi.org/10.1007/s43465-020-00086-7.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. JBJS. 2009;91(1).

    Google Scholar 

  5. Paprosky WG, Aribindi R. Hip replacement: treatment of femoral bone loss using distal bypass fixation. Instr Course Lect. 2000;49:119–30.

    CAS  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

  7. Sporer SM, Paprosky WG. Revision total hip arthroplasty: the limits of fully coated stems. Clin Orthop Relat Res. 2003;417:203–9. https://doi.org/10.1097/01.blo.0000096803.78689.0c.

    Article  Google Scholar 

  8. Khanuja HS, Vakil JJ, Goddard MS, Mont MA. Cementless femoral fixation in total hip arthroplasty. J Bone Joint Surg Am. 2011;93(5):500–9.

    Article  PubMed  Google Scholar 

  9. Berry DJ, Harmsen WS, Ilstrup D, Lewallen DG, Cabanela ME. Survivorship of uncemented proximally porous-coated femoral components. Clin Orthop Relat Res. 1995;319:168–77.

    Google Scholar 

  10. Sporer SM, Paprosky WG. Revision total hip arthroplasty: the limits of fully coated stems. Clin Orthop Relat Res. 2003;417:203–9.

    Article  Google Scholar 

  11. D’Antonio JA. Periprosthetic bone loss of the acetabulum. Classification and management. Orthop Clin North Am. 1992;23(2):279–90.

    Article  PubMed  Google Scholar 

  12. Sporer SM, Paprosky WG, O’Rourke MR. Managing bone loss in acetabular revision. Instr Course Lect. 2006;55:287–97.

    PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  14. Lachiewicz PF, Soileau ES. Fixation, survival, and dislocation of jumbo acetabular components in revision hip arthroplasty. J Bone Joint Surg Am. 2013;95(6):543–8.

    Article  PubMed  Google Scholar 

  15. von Roth P, Abdel MP, Harmsen WS, Berry DJ. Uncemented jumbo cups for revision total hip arthroplasty: a concise follow-up, at a mean of twenty years, of a previous report. J Bone Joint Surg Am. 2015;97(4):284–7.

    Article  Google Scholar 

  16. Köster G, Willert HG, Köhler HP, Döpkens K. An oblong revision cup for large acetabular defects: design rationale and two- to seven-year follow-up. J Arthroplast. 1998;13(5):559–69.

    Article  Google Scholar 

  17. DeBoer DK, Christie MJ. Reconstruction of the deficient acetabulum with an oblong prosthesis: three- to seven-year results. J Arthroplast. 1998;13(6):674–80.

    Article  CAS  Google Scholar 

  18. Berry DJ, Sutherland CJ, Trousdale RT, Colwell CWJ, Chandler HP, Ayres D, et al. Bilobed oblong porous coated acetabular components in revision total hip arthroplasty. Clin Orthop Relat Res. 2000;371:154–60.

    Article  Google Scholar 

  19. Moskal JT, Shen FH. The use of bilobed porous-coated acetabular components without structural bone graft for type III acetabular defects in revision total hip arthroplasty: a prospective study with a minimum 2-year follow-up. J Arthroplast. 2004;19(7):867–73.

    Article  Google Scholar 

  20. Abolghasemian M, Tangsaraporn S, Drexler M, Barbuto R, Backstein D, Safir O, et al. The challenge of pelvic discontinuity. Bone Joint J. 2014;96-B(2):195–200. https://doi.org/10.1302/0301-620X.96B2.31907.

    Article  CAS  PubMed  Google Scholar 

  21. Sheth NP, Melnic CM, Paprosky WG. Acetabular distraction: an alternative for severe acetabular bone loss and chronic pelvic discontinuity. Bone Joint J. 2014;96-B(11 Supple A):36–42.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mulpur, P., Suhas Masilamani, A.B., Guravareddy, A.V. (2023). Implant Selection in Revision Total Hip Arthroplasty. In: Sharma, M. (eds) Hip Arthroplasty. Springer, Singapore. https://doi.org/10.1007/978-981-99-5517-6_44

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-5517-6_44

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-5516-9

  • Online ISBN: 978-981-99-5517-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics