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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer-Verlag

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DOI

10.1002/sim.4780060411

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1434-3916

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Revision of failed acetabular components utilizing

Authors: Georg Köster Sabine Rading
Publish Date: 2008/04/01
Volume: 129, Issue: 5, Pages: 603-608
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Abstract

Failure of acetabular components often leads to bone loss with extensive elongated defects in the surrounding bone In these cases reconstruction is challenging and stable fixation of the revision implant difficult The use of an oblong cup has been described as an option for acetabular reconstruction in such revisions We report the first longterm results obtained with this implant to dateFiftysix longitudinal oblong revision cups LOR™ were evaluated clinically and radiologically after a followup of 8–12 years average 9 years The defects treated with the LOR™ cup ranged from Paprosky type 1–3 Allogenic cancellous bone chips were additionally used in 31 reconstructions to fill cavitary defectsBased on radiological criteria 50 acetabular implants underwent osseointegration without any definitive signs of loosening 2 consistently exhibited zonal radiolucent lines that were always smaller than 2 mm 1 migrated by around 3 mm None of these cases exhibited any clinical symptoms In 11 cases where acetabular defects manifested postoperatively 8 were remodeled completely and 3 partially at final followup Three revision implants migrated farther than 5 mm and had to be revised before 32month followup In addition 1 septic implant failure occurred After an average followup of 9 years 93 of the investigated implants remained in situ without further revision and 95 without aseptic implant failureThis 12year clinical study demonstrates that the LOR™ cup offers a successful concept for the revision of failed acetabular components that also promotes the biological reconstruction of bony defects Compared with other methods with similarly long followups our longterm results prove this procedure has a very low rate of revision and aseptic implant failure

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