Purpose: Although various papers have reported on the clinical performance of cup retention with cementation of a new liner and bone grafting in the management of well-fixed cups with polyethylene wear and periacetabular osteolysis after total hip arthroplasty (THA), no systematic review of this topic has been published to date.
Methods: Medline, EMBASE and Cochrane Library were searched for articles published from January 1999 to January 2019 using "osteolysis" AND "well-fixed", "osteolysis" AND "retro-acetabular", "bone graft" AND ("retention" OR "retained" OR "stable") AND "cup", and "cemented liner" AND "well-fixed".
Results: Nine articles were selected for review (186 cases, 76.1 months mean follow-up). The overall revision rate was 11.3% (21 hips) most commonly due to aseptic loosening (9/186 hips), dislocation (8/186 hips), and liner wear progression (2/186 cases). The reported square size of osteolytic lesions ranged from a mean of 465.84 mm to a max of 4,770 mm. Almost all reported lesions treated with bone grafts resolved or did not progress 97% (72/74). All studies indicated improved pain and functional scores at follow-up.
Conclusion: Cementation of a new liner with periacetabular bone grafting provides an alternative option to isolated liner exchange and cup revision for the management of periacetabular osteolysis in well-fixed cups with a disrupted locking mechanism or unavailable exchange liner. Further higher quality studies are required in order to examine if the use of highly cross-linked polyethylene, highly porous-coated cups, hydroxyapatite-coated cups, and small-diameter cups influence the clinical outcome of liner cementation in well-fixed cups with periacetabular osteolysis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00590-021-03130-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Isolated Liner Exchange and Bone Grafting for the Management of Periacetabular Osteolysis in Well-Fixed Cups with an Intact Locking Mechanism at Short-Term to Medium-Term Follow-Up: A Systematic Review.
HSS J
November 2024
The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA.
Polyethylene liner exchange and bone grafting is an effective surgical option for the management of periacetabular osteolysis following total hip arthroplasty with well-fixed cups and intact liner locking mechanisms. We aimed to evaluate the revision-free survivorship and radiographic lesion progression after polyethylene liner exchange and bone grafting is performed for periacetabular osteolysis. A systematic review of the literature was performed.
View Article and Find Full Text PDFFracture of an Exeter Femoral Stem With Extensive Ipsilateral Periacetabular Osteolysis.
Arthroplast Today
October 2024
Department of Orthopedic Surgery, McLaren Greater Lansing Hospital, Lansing, MI, USA.
The Stryker Exeter stem (Stryker, Kalamazoo, MI) has been in service for over 50 years and remains the most widely used cemented stem. Stem fracture is a rare complication, with recently reported rates of 1 in 10,000. We present a case of Exeter stem fracture 25 years following initial implantation as well as a large periacetabular defect secondary to osteolysis.
View Article and Find Full Text PDFResults of third generation dual mobility total hip arthroplasties with non-cross-linked polyethylene in patients under 60 years of age: comparative study of full pressfit vs. tripod cups after 8.6 years.
Orthop Traumatol Surg Res
October 2024
Département de Chirurgie Orthopédique du CHU de Caen Unité Inserm Comete 1075, Av. de la Côte de Nacre, 14000 Caen, France.
Background: The concept of dual mobility of total hip arthroplasties (THA) is a revolution in the prevention of dislocations and in the treatment of instability. Its use remains controversial in patients under 60 years old, providing poorer results with first generation cups coated with alumina. This study, carried out on modern dual mobility (DM) cups with a porous bilayer coating, in active patients under 60 years of age aimed to evaluate: (1) the mechanical survival of two latest generation DM THA, with failure defined as revision of acetabular or femoral implants for mechanical loosening, by comparing a tripod cup to a full pressfit cup, (2) to evaluate the complications, (3) to compare the rate of radiographic peri-prosthetic osteolysis between the 2 implants.
View Article and Find Full Text PDFThe Measurement of the Oxidative Index of Polyethylene Obtained during Revision Hip Arthroplasty and Assessment of Its Variability Depending on the Degree of Osteolysis, Implantation Time, as Well as the Size and Material of the Utilized Head.
J Clin Med
May 2024
Faculty of Science and Technology, University of Silesia in Katowice, ul. 75 Pułku Piechoty 1A, 41-500 Chorzów, Poland.
Aseptic loosening is the leading cause of late revision in total hip arthroplasty, primarily due to degenerative oxidation of polyethylene components, leading to wear particle formation and periacetabular osteolysis. This study aimed to analyze the oxidation levels in polyethylene liners and cemented cups retrieved from revision surgeries using Fourier-transform infrared spectroscopy (FTIR) and to explore the correlation between oxidation levels and factors such as head size, head material, fixation method, and implant survival time. Polyethylene liners and cups were analyzed post-revision surgery to assess oxidation levels, which were then compared to periacetabular bone loss measured by the Paprosky classification.
View Article and Find Full Text PDF20-year Results of a 3D Titanium Mesh Coating Stability of 31 Artificial Cups.
Z Orthop Unfall
June 2024
Orthopädie und Unfallchirurgie, GFO- Kliniken Troisdorf, Troisdorf, Deutschland.
Background: The aim of this work was to demonstrate the bony bond strength and resilience of a three-dimensional titanium mesh coating of an artificial acetabulum produced using the diffusion bonding technique. Under the extreme conditions ranging from abrasion-related osteolysis to acetabular perforation, the degree of residual bone and the integrity of the coating were determined. The remaining zones of the (still) stable bone connection are inevitably exposed to a greater load of the layer adhesion between the titanium mesh and the core shell.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!