Revision Total Hip Arthroplasty Using a Cementless Acetabular Component

Abstract

Are the midterm results (range, 7-11 years) for revision of the acetabulum with a cementless hemispherical component comparable with other published revision techniques at similar followup? One hundred thirty-eight acetabular revisions for aseptic loosening were done in 132 patients using a cementless hemispherical component coated with titanium mesh and inserted with supplemental screw fixation. Twelve patients died, 9 were lost to followup, and 6 could not return for followup, leaving 111 patients (115 hips) with a mean of 100 months of followup. Thirteen hips required revision (11%): 4 were done for recurrent dislocations, and 6 for sepsis; 3 stable cups were revised (at the time of stem revision). No cup was revised for aseptic loosening. Radiographic review was available for 105 patients (109 hips) at mean 98-month followup (78-135 months). A complete radiolucency was seen in 4% of the cups, a partial progressive radiolucency in 3%, and a partial nonprogressive radiolucency in 54%; no radiolucency was present in 39%. A screw radiolucency was seen in 2%, and osteolysis at the cup margin in 4%. Revision of the acetabulum with a cementless porous-coated hemispherical fiber-metal component is superior to the results reported for acetabular revisions with cement at similar followup.