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Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects

Purpose: Patient-specific, flanged acetabular components are used for the treatment of Paprosky type III defects during revision total hip arthroplasty (THA). This monocentric retrospective cohort study analyzes the outcome of patients treated with custom made monoflanged acetabular components (CMAC...

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Autores principales: von Hertzberg-Boelch, Sebastian Philipp, Wagenbrenner, Mike, Arnholdt, Jörg, Frenzel, Stephan, Holzapfel, Boris Michael, Rudert, Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068245/
https://www.ncbi.nlm.nih.gov/pubmed/33917821
http://dx.doi.org/10.3390/jpm11040283
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author von Hertzberg-Boelch, Sebastian Philipp
Wagenbrenner, Mike
Arnholdt, Jörg
Frenzel, Stephan
Holzapfel, Boris Michael
Rudert, Maximilian
author_facet von Hertzberg-Boelch, Sebastian Philipp
Wagenbrenner, Mike
Arnholdt, Jörg
Frenzel, Stephan
Holzapfel, Boris Michael
Rudert, Maximilian
author_sort von Hertzberg-Boelch, Sebastian Philipp
collection PubMed
description Purpose: Patient-specific, flanged acetabular components are used for the treatment of Paprosky type III defects during revision total hip arthroplasty (THA). This monocentric retrospective cohort study analyzes the outcome of patients treated with custom made monoflanged acetabular components (CMACs) with intra- and extramedullary iliac fixation. Methods: 14 patients were included who underwent revision THA with CMACs for the treatment of Paprosky type III defects. Mechanism of THA failure was infection in 4 and aseptic loosening in 10 patients. Seven patients underwent no previous revision, the other seven patients underwent three or more previous revisions. Results: At a mean follow-up of 35.4 months (14–94), the revision rate of the implant was 28.3%. Additionally, one perioperative dislocation and one superficial wound infection occurred. At one year postoperatively, we found a significant improvement of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score (p = 0.015). Postoperative radiographic analysis revealed good hip joint reconstruction with a mean leg length discrepancy of 3 mm (−8–20), a mean lateralization of the horizontal hip center of rotation of 8 mm (−8–35), and a mean proximalization of the vertical hip center of rotation of 6 mm (13–26). Radiolucency lines were present in 30%. Conclusion: CMACs can be considered an option for the treatment of acetabular bone loss in revision THA. Iliac intra- and extramedullary fixation allows soft tissue-adjusted hip joint reconstruction and improves hip function. However, failure rates are high, with periprosthetic infection being the main threat to successful outcome.
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spelling pubmed-80682452021-04-25 Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects von Hertzberg-Boelch, Sebastian Philipp Wagenbrenner, Mike Arnholdt, Jörg Frenzel, Stephan Holzapfel, Boris Michael Rudert, Maximilian J Pers Med Article Purpose: Patient-specific, flanged acetabular components are used for the treatment of Paprosky type III defects during revision total hip arthroplasty (THA). This monocentric retrospective cohort study analyzes the outcome of patients treated with custom made monoflanged acetabular components (CMACs) with intra- and extramedullary iliac fixation. Methods: 14 patients were included who underwent revision THA with CMACs for the treatment of Paprosky type III defects. Mechanism of THA failure was infection in 4 and aseptic loosening in 10 patients. Seven patients underwent no previous revision, the other seven patients underwent three or more previous revisions. Results: At a mean follow-up of 35.4 months (14–94), the revision rate of the implant was 28.3%. Additionally, one perioperative dislocation and one superficial wound infection occurred. At one year postoperatively, we found a significant improvement of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score (p = 0.015). Postoperative radiographic analysis revealed good hip joint reconstruction with a mean leg length discrepancy of 3 mm (−8–20), a mean lateralization of the horizontal hip center of rotation of 8 mm (−8–35), and a mean proximalization of the vertical hip center of rotation of 6 mm (13–26). Radiolucency lines were present in 30%. Conclusion: CMACs can be considered an option for the treatment of acetabular bone loss in revision THA. Iliac intra- and extramedullary fixation allows soft tissue-adjusted hip joint reconstruction and improves hip function. However, failure rates are high, with periprosthetic infection being the main threat to successful outcome. MDPI 2021-04-08 /pmc/articles/PMC8068245/ /pubmed/33917821 http://dx.doi.org/10.3390/jpm11040283 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
von Hertzberg-Boelch, Sebastian Philipp
Wagenbrenner, Mike
Arnholdt, Jörg
Frenzel, Stephan
Holzapfel, Boris Michael
Rudert, Maximilian
Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
title Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
title_full Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
title_fullStr Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
title_full_unstemmed Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
title_short Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects
title_sort custom made monoflange acetabular components for the treatment of paprosky type iii defects
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068245/
https://www.ncbi.nlm.nih.gov/pubmed/33917821
http://dx.doi.org/10.3390/jpm11040283
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