Background: Trabecular Metal (TM) augments are one option when reconstructing bone loss during acetabular side revision surgery.
Methods: We studied 38 consecutive patients with Paprosky type 3 defects that were revised using a TM shell and one or more augments over a 6-year period. There were 29 Paprosky type 3A defects and 9 Paprosky type 3B defects. The mean age of the patients at the time of surgery was 68.2 years (range 48-84). The mean length of follow-up was 36 months (range 18-74).
Results: The mean preoperative short form 12 health survey improved from 27.7 before operation to 30.1 at the time of final follow-up (P = .001). The mean Western Ontario and McMaster Universities Osteoarthritis Index score improved from 53 preoperatively to a mean of 78.8 at final follow-up (P < .0001). There was evidence of radiographic loosening in 7 of the cup-augment constructs. One patient developed a deep infection requiring re-revision. Two patients required revision for aseptic loosening.
Conclusion: The use of TM in complex acetabular reconstruction is associated with good outcome in the short to medium term.
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http://dx.doi.org/10.1016/j.arth.2017.10.031 | DOI Listing |
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
January 2025
Department of Artificial Joint Revision, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Zhengzhou Henan, 450003, P. R. China.
Objective: To analyze the short-term effectiveness and safety of personalized three-dimensional (3D) printed customized prostheses in severe Paprosky type Ⅲ acetabular bone defects.
Methods: A retrospective analysis was conducted on 8 patients with severe Paprosky type Ⅲ acetabular bone defects and met the selection criteria between January 2023 and June 2024. There were 3 males and 5 females, with an average age of 64.
J Orthop Case Rep
January 2025
Department of Orthopaedic, Sunshine Bone and Joint Insitute, KIMS-Sunshine Hospitals, Hyderabad, Telangana, India.
Introduction: Total hip arthroplasty (THA) is recognized as one of the most effective surgical procedures for the treatment of end-stage hip arthritis. However, the increasing number of primary THA cases has led to a corresponding rise in the frequency of revision surgeries, which are often more complex and challenging due to severe acetabular bone loss. In such cases, managing Paprosky type 3A and 3B defects requires precise implant design and advanced surgical techniques.
View Article and Find Full Text PDFJ Clin Orthop Trauma
December 2024
Orthopaedic and Trauma Surgeon, AO Hospital, Karachi, Pakistan.
Background: The tapered fluted titanium stem is a viable option for complex hip reconstruction. We therefore, evaluate the results of complex hip arthroplasty for femoral bone loss (Paprosky type IIIA to type IV femoral defect), using a modular fluted titanium stem.
Methods: Data for this retrospective study was collected from the medical records of the 2 participating orthopaedic units from December 2018 to December 2021.
Arch Orthop Trauma Surg
December 2024
Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, People's Republic of China.
Purpose: The purposes of this study was to develop a novel therapy-oriented acetabular bone defects classification system based on Statistical shape models (SSMs) and evaluate the reliability and reproducibility of its application.
Methods: We retrospectively reviewed and annotated pelvic Computed tomography (CT) of patients who had undergone revision total hip arthroplasty at our institution and constructed a dataset to develop the novel method for quantitatively describing acetabular bone defects that is based on SSMs. Then, using this method, classification systems are suggestive for diagnosis and corresponding treatment suggestion.
J Exp Orthop
October 2024
Reconstructive Orthopaedic Surgery Innovative Techniques-Musculoskeletal Tissue Bank IRCCS Istituto Ortopedico Rizzoli Bologna Italy.
Purpose: Many treatment options are available for the revision of large acetabular defects. Debate continues as to which technique is most effective. This meta-analysis aimed to determine the rates of failure of acetabular bone defects Paprosky type III or American Academy of Orthopaedic types III-IV treated with morselized allograft in association with cemented cup or cementless cup or reinforcement devices.
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