Hip Pelvis.
2023 Jun;35(2):122-132. 10.5371/hp.2023.35.2.122.
The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes
- Affiliations
-
- 1Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- 2Department of Orthopedic Surgery, Newton-Wellesley Hospital, Newton, MA, USA
- 3Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
- 4Department of Orthopaedic Surgery, Section of Adult Joint Reconstruction, Rush Presbyterian-St. Luke’s Medical Center, Chicago, IL, USA
- 5Pennsylvania Hospital, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- KMID: 2549135
- DOI: http://doi.org/10.5371/hp.2023.35.2.122
Abstract
- Purpose
The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique.
Materials and Methods
A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired.
Results
The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement.
Conclusion
Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.
