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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8068245 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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