PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 12820085

Acetabular revision without cement.

Tze-Pui Ng·Kwong-Yuen Chiu
View original source ↗Export metadata ↓

Abstract

We reviewed the clinical and radiologic results of 47 cementless acetabular revisions performed by a single surgeon. The mean follow-up period was 58 months. The American Academy of Orthopaedic Surgeons (AAOS) acetabular defect classification was type I in 4 hips, type II in 9 hips, and type III in 32 hips. All patients received AML (Depuy, Warsaw, IN) Duraloc cup implants. Morcellized allograft was used in 23 hips (49%), and screw augmentation in 22 hips (47%). The Harris Hip score improved from 72 to 90 points. No revisions were performed for aseptic loosening. Nonprogressive thin radiolucent lines were found in a single zone in 10 hips (21%) and in all 3 zones in 5 hips (11%). No migration was found in any cups with radiolucent lines, and the presence of a radiolucent line was considered clinically unimportant. Progressive loosening with migration of the cup was found in 1 hip (2%). Kaplan-Meier survivorship using revision for aseptic loosening or radiologic loosening as end points was 92% at 72 months. No statistically significant difference was found in the survival of the cups fixed with or without screws. These encouraging midterm results confirm the role of cementless acetabular revision.

Explore related subjects

AcetabulumAdultAgedArthroplasty, Replacement, HipFemaleFollow-Up StudiesHumansMaleMiddle AgedProsthesis FailureRadiographyReoperationSurvival AnalysisTreatment OutcomeJournal ArticleResearch Support, Non-U.S. Gov't

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Tze-Pui Ng, Kwong-Yuen Chiu. 2003. Acetabular revision without cement.. https://doi.org/10.1016/s0883-5403(03)00019-6

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2004

Extensile triradiate approach in the management of combined acetabular fractures.

INTRODUCTION: We investigated the results of combined acetabular fractures that were treated through the extensile triradiate approach in this study. MATERIALS AND METHODS: Between January 1996 and January 2001, a total of 48 acetabular fractures were treated surgically (mainly combined fractures). Twenty-five of the combined acetabular fractures that were surgically treated through the triradiate approach with a minimum of 2 years' follow-up were included in the study. The mean patient age was 42 years. There were 8 both-column, 6 T-shaped, 2 anterior column/posterior hemitransverse, 4 transverse with comminuted roof area, 4 posterior wall with comminuted roof area, and 1 posterior column/posterior wall fracture. Associated injuries included two full-thickness chondral injuries of the head, one Pipkin type II fracture, five posterior and one central dislocation of the ipsilateral femoral head, and acetabular marginal impaction in four hips. The average follow-up was 44 months. RESULTS: The postoperative reduction was graded as excellent in 68% and imperfect in 8% of the patients. The hips were evaluated functionally according to the modified Postel-D'Aubigne score and rated as excellent in 7 patients (28%), good in 13 patients (52%), fair in 3 patients (12%) and poor in 2 patients (8%). There were 2 deep infections (8%), 2 avascular necroses of the head (8%), and 4 (16%) non-disabling heterotopic ossifications. CONCLUSION: Our results support the idea that open reduction with the triradiate approach provides good visualization and direct reduction of combined acetabular fractures. Its learning curve for combined fractures is shorter than that for single approaches and provides at least the same rate of anatomical reduction. It should be in the armamentarium of a surgeon dealing with such fractures.

Acetabulum↗
PubMed2004

Radiographic and magnetic resonance imaging findings of polylevolactic acid screws after rotational acetabular osteotomy.

INTRODUCTION: Biodegradable polylevolactic acid implants have become more commonly used for the treatment of fractures and osteotomies over the past few years. In the present study, the biocompatibility and degradation of polylevolactide screws used for rotational acetabular osteotomy were assessed on the basis of radiographic and MRI findings. MATERIALS AND METHODS: Forty-nine hips of 47 patients were analyzed for this study. The average age of the patients at the time of surgery was 38.0 years (range 18-62 years). The original diagnosis was osteoarthritis in 43 hips and osteonecrosis in 6 hips. The mean duration of follow-up was 2.8 years (range 1.5-5.5 years). Anteroposterior radiographs obtained at 1 week, 6 months, 1 year after the operation, as well as the most recent radiographs, were used to assess bony union, the radiolucent tract of each screw, and the sclerotic rim around each screw. Fifteen patients were chosen randomly to undergo MRI. RESULTS: Union of the osteotomized surfaces occurred in all patients within 6 months of surgery. Radiographs showed no osteolysis, no formation of bone cysts, and no displacement of the osteotomized acetabulum in any of the 49 hips. None of the patients was found to have any complications caused by problems with the biocompatibility of the implants. At the final postoperative examination, a central radiolucent tract and a sclerotic rim around the screws were seen in 34/49 hips (69%) and 23/49 hips (47%), respectively. On MRI findings, we were able to detect significant resorption of the screws in two patients after 1.2 and 1.7 years of follow-up. Though localized low-intensity areas on T1-weighted images and high-intensity areas on T2-weighted images were observed at the top of the screws in 5 patients, there was no development of pain, tenderness, or a sinus during the follow-up period. CONCLUSION: Although absorption of polylevolactic acid screws did not occur in a large majority of cases, rotational acetabular osteotomy appears to be a good indication for the use of polylevolactic acid screws.

Acetabulum↗
PubMed2004

Radiographic hip osteoarthritis and acetabular dysplasia in Turkish men and women.

The prevalence of hip osteoarthritis (OA) varies with different regions, and the reasons for this remain unclear. Mild acetabular dysplasia has been considered a risk factor for hip OA, but recent studies have not confirmed this. In Turkey, the prevalence of significant radiographic hip OA, i.e. Kellgren-Lawrence (K-L) grades 3 and 4, is lower than in Western populations. We aimed to investigate the potential effects of radiographic measures of acetabular dysplasia on this discrepancy. Ninety-two Turkish patients (65 males, 27 females) aged 55 and over were studied. Plain supine abdominal radiographs and intravenous pyelographs were evaluated. Centre-edge (CE) angle and acetabular depth (AD) of each hip were measured, and K-L grading was done. The mean CE angles +/- SD of right and left hips were 34+/-7 degrees and 35+/-7 degrees (range 14-52 and 18-50), respectively. The mean AD+/-SD of right and left hips was 13.7+/-3.4 and 13.6+/-3.4 (range 6-23 and 8-25), respectively. Mean CE angle or acetabular depth of the hips with K-L grade 2 did not differ from those with grades 0 and 1. There was no patient with grade 3 or 4. The prevalence of acetabular dysplasia based on a CE angle of <25 degrees was 9.8% in both right and left hips. When it was defined as having an AD of <9 mm, the prevalence was 4.3% and 1.1% in the right and left hips, respectively. Overall, 10.4% of the hips (13% of the men and 3.7% of the women) had acetabular dysplasia based on at least one of these measurements. Mild acetabular dysplasia appears to be relatively common among Turks aged 55 and over. However, it does not seem to play a major role in the development of radiographic hip OA.

Acetabulum↗