دورية أكاديمية
Highly Porous Acetabular Cup and Augment Constructs in Complex Revision Total Hip Arthroplasty: What Predicts 10-Year Implant Survivorship?
| العنوان: | Highly Porous Acetabular Cup and Augment Constructs in Complex Revision Total Hip Arthroplasty: What Predicts 10-Year Implant Survivorship? |
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| المؤلفون: | Alter TD; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Hadley ML; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Couch CG; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Fruth KM; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Bedard NA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Perry KI; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Sierra RJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota., Lewallen DG; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota. |
| المصدر: | The Journal of arthroplasty [J Arthroplasty] 2024 Sep; Vol. 39 (9S1), pp. S194-S202. Date of Electronic Publication: 2024 Apr 09. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New Brunswick, NJ : Taylor and Francis Original Publication: [New York, NY : Churchill Livingstone, c1986- |
| مواضيع طبية MeSH: | Arthroplasty, Replacement, Hip*/instrumentation , Reoperation*/statistics & numerical data , Acetabulum*/surgery , Hip Prosthesis* , Prosthesis Failure* , Tantalum* , Prosthesis Design*, Humans ; Female ; Male ; Middle Aged ; Aged ; Adult ; Aged, 80 and over ; Porosity ; Retrospective Studies ; Radiography ; Follow-Up Studies ; Treatment Outcome |
| مستخلص: | Background: Porous tantalum acetabular cup and augment constructs have demonstrated favorable outcomes up to 5 years postsurgery despite severe bone loss during revision total hip arthroplasty (THA). Prior literature lacks long-term studies with substantial case numbers. This study aims to assess long-term clinical and radiographic outcomes 10 years postsurgery in patients undergoing revision THA with porous tantalum acetabular cup-augment constructs and determine factors associated with long-term survivorship. Methods: Between 2000 and 2012, 157 revision THAs were performed in cases with major acetabular defects (mainly Paprosky type IIIA and IIIB) utilizing porous tantalum cup-augment constructs. Pelvic discontinuity was noted intraoperatively in 17 hips (11%). Postoperative radiographs were evaluated at regular intervals for implant stability and radiolucent lines. There were 49 patients who had complete radiographic follow-up at 10 years or longer postsurgery. Results: The 10-year survivorship free of revision of the cup-augment construct for aseptic loosening was 93%, free of any acetabular construct revision was 91%, free of any hip rerevision was 77%, and free of any reoperation was 75%. Pelvic discontinuity was associated with increased risk of reoperation (hazard ratio [HR] = 2.8), any hip rerevision (HR = 3.2), any cup-augment construct revision (HR = 11.8), and aseptic construct revision (HR = 10.0). Of unrevised cases with radiographs at 10 years, 4 hips showed radiographic loosening. Mean Harris hip scores improved from 47 preoperatively to 79 at 10 years. Conclusions: Porous tantalum acetabular cup-augment constructs used in revision THA with severe acetabular bone loss provide excellent implant survivorship at 10 years when the acetabulum is intact. Due to lower survivorship of cup-augment constructs in cases of pelvic discontinuity, additional construct fixation or stabilization methods are recommended, when a discontinuity is present. Level of Evidence: IV. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: acetabular bone loss; pelvic discontinuity; porous tantalum augment; porous tantalum cup; revision; total hip arthroplasty |
| المشرفين على المادة: | 6424HBN274 (Tantalum) |
| تواريخ الأحداث: | Date Created: 20240410 Date Completed: 20240817 Latest Revision: 20240817 |
| رمز التحديث: | 20240818 |
| DOI: | 10.1016/j.arth.2024.03.071 |
| PMID: | 38599525 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-8406 |
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| DOI: | 10.1016/j.arth.2024.03.071 |