Hip Pelvis.  2016 Jun;28(2):98-103. 10.5371/hp.2016.28.2.98.

Revision Total Hip Arthroplasty Using Tantalum Augment in Patients with Paprosky III or IV Acetabular Bone Defects: A Minimum 2-year Follow Up Study

• Jeong M
• Kim HJ
• Lim SJ
• Moon YW
• Park YS

• KMID: 2328345
• DOI: http://doi.org/10.5371/hp.2016.28.2.98

Abstract

PURPOSE
The purpose of this study is to report the short-term outcomes of revision total hip arthroplasty (THA) using tantalum augments in patients with severe acetabular bone defects.
MATERIALS AND METHODS
We retrospectively analyzed 15 revision THAs performed in 15 patients using tantalum augments between June 2010 and December 2013. Acetabular bone defects were Paprosky type IIIA in 7 hips, type IIIB in 7, and type IV in 1. The causes of revision surgery were aseptic loosening in 12 hips and deep infection in 3. Revisions were first in 1 hip, second in 3, and third in 11. Six patients were male and 9 female with a mean age of 59 years (range, 48-75 years). Mean follow-up was 29 months (range, 24-48 months).
RESULTS
Mean Harris hip score was improved from 34 points (range, 12-54 points) preoperatively to 84 points (range, 38-90 points) at final follow-up. On the final follow-up radiographs, there were 12 hips (80.0%) with stable fixation of the acetabular cup, 2 (13.3%) with secondary stability after mild acetabular protrusion, and 1 (6.7%) with radiolucency around the acetabular cup without mechanical symptoms. Complications included one patient with acute hematogenous infection managed by surgical debridement and long-term antibiotic therapy. There were no cases with nerve palsy or dislocation during the follow-up period.
CONCLUSION
The present study showed satisfactory clinical and radiographic outcomes of revision THA using tantalum augments due to severe acetabular bone defects of Paprosky type III or IV at a minimum follow-up of 2 years.

Keyword

Revision total hip arthroplasty; Acetabular bone defect; Tantalum augment

MeSH Terms

Acetabulum*
Arthroplasty, Replacement, Hip*
Debridement
Dislocations
Female
Follow-Up Studies*
Hip
Humans
Male
Paralysis
Retrospective Studies
Tantalum*
Tantalum

Figure

• 

  Fig. 1 (A-C) A 64-year-old female patient with failed revision total hip arthroplasty using antiprotrusio cage and morselized allograft associated pelvic discontinuity (Paprosky type IV acetabular defect). (D) Radiograph 2 years after acetabular reconstruction using jumbo cup and tantalum augment showing a well-maintained acetabular construct.

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