Revision of Total Hip Replacement with Acetabular Deficiency

Abstract

Background: The paradigm of revision surgery has been evolving constantly. There is a wide range of surgical options for successful reconstruction. Objective: This study aimed to evaluate the results of reconstruction techniques in acetabular deficiency. Patients and methods: A prospective interventional designincluded patients with acetabular deficiency who were admitted to Orthopedic Department at Zagazig University Hospitals. We had 10 patients with acetabular deficiency (Three were classified as Paprosky IIIA; one of them was AAOS IIB and two were AAOS III, Two were classified as Paprosky IIIB and AAOS III, Two were classified as Paprosky IIA and AAOS IIA; one was Paprosoky IIB and AAOS IIB and Two patients were classified as Paprosky IIC; one of them was AAOS IIB and the other was AAOS III). The evaluation and follow up of patients depended mainly on the Harris hip score, which evaluates the patient clinically preoperatively and postoperatively. Results: All the patients reached full weight bearing between 7 and 9 weeks after surgery. Revision total hip replacement (THR) was the treatment of choice for patients with severe groin pain and apparent acetabular deficiency. Restoration of the normal center of rotation was essential for the joint biomechanics and survival of the prosthesis. Conclusion: There was no method of reconstruction of acetabulum superior to another method; each method had specific indication, which differs according to the percentage of acetabular coverage and bone stock. Patients with mild to moderate acetabular deficiency (Paprosky I, IIA and IIB) were managed by using acetabular augmentation graft or small acetabular component with medialization. Keywords: