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Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty

BACKGROUND: The preoperative bone defect and the reconstruction of the center of rotation of the hip are critical in acetabular revision surgery. Uncemented oblong cups are employed in order to manage these issues. We analyzed the clinical results and rates of revision of two different uncemented ob...

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Autores principales: García-Rey, Eduardo, Fernández-Fernández, Ricardo, Durán, David, Madero, Rosario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3585906/
https://www.ncbi.nlm.nih.gov/pubmed/23160803
http://dx.doi.org/10.1007/s10195-012-0217-8
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author García-Rey, Eduardo
Fernández-Fernández, Ricardo
Durán, David
Madero, Rosario
author_facet García-Rey, Eduardo
Fernández-Fernández, Ricardo
Durán, David
Madero, Rosario
author_sort García-Rey, Eduardo
collection PubMed
description BACKGROUND: The preoperative bone defect and the reconstruction of the center of rotation of the hip are critical in acetabular revision surgery. Uncemented oblong cups are employed in order to manage these issues. We analyzed the clinical results and rates of revision of two different uncemented oblong cups, the reconstruction of the center of rotation of the hip, as well as the rate of radiological loosening and possible risk factors. MATERIALS AND METHODS: Forty-five patients (46 hips) underwent acetabular revision surgery using two different uncemented oblong cups. We assessed the clinical results and the survival rate for revision and aseptic loosening. Intraoperative bone loss was classified according to Paprosky, and acetabular reconstruction was assessed according to Ranawat. The mean follow-up was 7.2 years (range 4–11 years). RESULTS: There were four re-revisions (three due to aseptic loosening); the survival rate for re-revision due to aseptic loosening was 60.1 % at seven years. The mean distance between the center of the femoral head prosthesis and the approximate center of the femoral head improved from 21.5 to 10.2 mm. Thirteen cups showed radiological loosening; the survival rate for radiological loosening at seven years was 40.54 %. A smaller postoperative horizontal distance was correlated with cup loosening. CONCLUSIONS: Although optimal acetabular reconstruction can be achieved by using oblong uncemented cups in revision hip surgery, the clinical and radiological results are not encouraging. Excessive medialization of the cup may increase the rate of loosening.
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spelling pubmed-35859062013-03-07 Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty García-Rey, Eduardo Fernández-Fernández, Ricardo Durán, David Madero, Rosario J Orthop Traumatol Original Article BACKGROUND: The preoperative bone defect and the reconstruction of the center of rotation of the hip are critical in acetabular revision surgery. Uncemented oblong cups are employed in order to manage these issues. We analyzed the clinical results and rates of revision of two different uncemented oblong cups, the reconstruction of the center of rotation of the hip, as well as the rate of radiological loosening and possible risk factors. MATERIALS AND METHODS: Forty-five patients (46 hips) underwent acetabular revision surgery using two different uncemented oblong cups. We assessed the clinical results and the survival rate for revision and aseptic loosening. Intraoperative bone loss was classified according to Paprosky, and acetabular reconstruction was assessed according to Ranawat. The mean follow-up was 7.2 years (range 4–11 years). RESULTS: There were four re-revisions (three due to aseptic loosening); the survival rate for re-revision due to aseptic loosening was 60.1 % at seven years. The mean distance between the center of the femoral head prosthesis and the approximate center of the femoral head improved from 21.5 to 10.2 mm. Thirteen cups showed radiological loosening; the survival rate for radiological loosening at seven years was 40.54 %. A smaller postoperative horizontal distance was correlated with cup loosening. CONCLUSIONS: Although optimal acetabular reconstruction can be achieved by using oblong uncemented cups in revision hip surgery, the clinical and radiological results are not encouraging. Excessive medialization of the cup may increase the rate of loosening. Springer International Publishing 2012-11-17 2013-03 /pmc/articles/PMC3585906/ /pubmed/23160803 http://dx.doi.org/10.1007/s10195-012-0217-8 Text en © The Author(s) 2012 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Article
García-Rey, Eduardo
Fernández-Fernández, Ricardo
Durán, David
Madero, Rosario
Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
title Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
title_full Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
title_fullStr Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
title_full_unstemmed Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
title_short Reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
title_sort reconstruction of the rotation center of the hip after oblong cups in revision total hip arthroplasty
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3585906/
https://www.ncbi.nlm.nih.gov/pubmed/23160803
http://dx.doi.org/10.1007/s10195-012-0217-8
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