Cementless acetabular reconstruction in revision total hip arthroplasty.

Abstract

Reconstruction of the failed acetabular component in total hip arthroplasty (THA) can be challenging. Although there are multiple reconstructive options available, a cementless acetabular component inserted with screws has been shown to have good intermediate-term results and is the reconstructive method of choice for the majority of acetabular revisions. We reviewed the results of 138 consecutive acetabular revisions done with a hemispheric, cementless acetabular component that is sintered with Ti fiber metal mesh and was inserted with line-to-line reaming and multiple screws for fixation. At a mean of 15 years, 19 acetabular components had been revised (13.8%); seven were revised for recurrent instability, six were revised for deep periprosthetic infection, five well-fixed cups were removed at the time of femoral revision, and one cup was fixed by fibrous tissue only at the time of femoral revision and was removed. One acetabular component was radiographically loose. Survivorship of the component was 81% at 15 years when revision for any reason was considered as an end point and 96% when revision for loosening or radiographic evidence of loosening was considered as a second end point. Cementless acetabular revision provides durable results at 15 years with a low rate of failure for loosening.