Cup revision involving retention of a fixed but malpositioned acetabular component in patients with poor general conditions

This study evaluated the surgical technique and outcomes of cup revision involving retention of a fixed but malpositioned acetabular component in patients with poor general conditions. Between 2007 and 2013, we performed cup revision on 12 hips while retaining a fixed (either cemented or uncemented) but malpositioned acetabular component. Indications for this technique were: malpositioned but fixed acetabular shell; sufficient space for the insertion of the prosthesis; and patients with poor general conditions. After intraoperative confirmation of shell stability, a replacement liner was oriented in a new plane. Clinical and imaging data were collected perioperatively and during follow-up for evaluation of surgical efficacy. No intraoperative complications were encountered. Mean operative duration was 70.4 minutes (range, 45–90 minutes) and mean estimated blood loss was 729 mL (range, 400–1200 mL). Mean follow-up duration was 5.1 years (range, 2.5–8.5 years). Average visual analog scale score decreased from (7.08 ± 1.00) preoperatively to (1.42 ± 0.67) at final follow-up (P < .05). Average Harris Hip Score improved from (14.7 ± 6.58) preoperatively to (80.9 ± 5.30) at final follow-up (P < .05). Anteversions and inclinations of new liners were (15.1 ± 2.3)° and (46.4 ± 3.9)° respectively. Postoperative radiographs showed no signs of prosthesis loosening, periprosthetic fractures, or dislocation compared with preoperatively. The short-term efficacy of cup revision with retention of a malpositioned but fixed acetabular component was satisfactory.