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Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact

  • Symposium: Papers Presented at the Annual Closed Meeting of the International Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Acetabular component revision in the context of large contained bone defects with less than 50% host bone contact traditionally have been treated with roof reinforcement or antiprotrusio cages. Trabecular Metal™ cups (Zimmer, Inc, Warsaw, IN) may offer a reasonable treatment alternative. We evaluated the clinical and radiographic outcome of this mode of treatment. We prospectively followed 53 hip revision acetabular arthroplasty procedures performed with Trabecular Metal™ cups for contained defects with 50% or less contact with native bone. All patients were clinically and radiographically evaluated for evidence of loosening or failure. Minimum followup was 24 months (average, 45 months; range, 24–71 months). Contact with host bone ranged from 0% to 50% (average, 19%). The mean postoperative Merle d’Aubigne-Postel score was 10.6 (range, 1–12), with a mean improvement of 5.2 (range, −4–10) compared to the preoperative score. Two failed cups (4%) were revised. Two additional cups (4%) had radiographic evidence of probable loosening. Complications included four dislocations and one sciatic nerve palsy. The data suggest treatment of cavitary defects with less than 50% host bone contact using Trabecular Metal™ cups, without structural support by augments or structural bone grafts, is a reasonable option.

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

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Authors and Affiliations

  1. Orthopedic Department, Division of Arthroplasty, Mount Sinai Hospital, 600 University Avenue, Suite 476A, Toronto, ON, M5G 1X5, Canada

    Dror Lakstein MD, David Backstein MD, MEd, FRCSC, Oleg Safir MD, FRCSC, Yona Kosashvili MD, MHA & Allan E. Gross MD, FRCSC

Authors
  1. Dror Lakstein MD
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  2. David Backstein MD, MEd, FRCSC
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  3. Oleg Safir MD, FRCSC
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  4. Yona Kosashvili MD, MHA
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  5. Allan E. Gross MD, FRCSC
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Correspondence to Dror Lakstein MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Lakstein, D., Backstein, D., Safir, O. et al. Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact. Clin Orthop Relat Res 467, 2318–2324 (2009). https://doi.org/10.1007/s11999-009-0772-3

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  • DOI: https://doi.org/10.1007/s11999-009-0772-3

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