Revision of the Acetabular Component without Cement: A Concise Follow-up, at Twenty to Twenty-four Years, of a Previous Report

Park, Daniel K.; Della Valle, Craig J.; Quigley, Laura; Moric, Mario; Rosenberg, Aaron G.; Galante, Jorge O.
February 2009
Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p350
Academic Journal
We previously reported the results of the use of a cementless acetabular shell for revision total hip arthroplasty in 138 hips at a minimum of three, seven, and fifteen years postoperatively. The current report presents the long-term outcomes of this group at a minimum follow-up of twenty years. Since the last report, two additional hips required repeat revision, both for infection; no additional acetabular shell was loose. In the entire series to date, repeat acetabular revision was performed in twenty-one (15%) of the original 138 hips. Twenty of the twenty-one shells were well fixed at the time of repeat revision, and one had become aseptically loose. The most common reasons for repeat revision were infection (eight hips) and recurrent instability (eight hips). In the metal shells that were well fixed, an isolated liner change for polyethylene wear and/or osteolysis was performed in a total of six hips; four of these liner exchanges were performed since the time of our last report. A liner change had been recommended because of severe wear in four additional hips; thus, 18% of the fifty-six unrevised metal shells were associated with polyethylene wear-related problems. Survivorship, with revision of the shell for aseptic loosening or radiographic evidence of loosening as the end point, was 95% at twenty years (95% confidence interval, 83% to 98%). Reoperations for wear and osteolysis were first seen at approximately twelve years postoperatively. At the time of the present long-term follow-up, the reoperation rate for polyethylene wear and/or osteotysis had increased. We continue to use a hemispherical, titanium metal shell with multiple screws for fixation in the majority of acetabular revisions. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • Strategies for head and inlay exchange in revision hip arthroplasty. Pospischill, Martin; Knahr, Karl // International Orthopaedics;Feb2011, Vol. 35 Issue 2, p261 

    Due to the increasing number of total hip arthroplasties performed during the last three decades and the limited long-term survival, mainly because of wear, the number of revisions has increased during the last two years. If the implant itself is still considered to be stable, only head and...

  • REVISION OF THE ACETABULAR COMPONENT WITHOUT CEMENT AFTER TOTAL HIP ARTHROPLASTY. Della Valle, Craig J.; Shuaipaj, Tasin; Berger, Richard A.; Rosenberg, Aaron G.; Shott, Susan; Jacobs, Joshua J.; Galante, Jorge O. // Journal of Bone & Joint Surgery, American Volume;Aug2005, Vol. 87-A Issue 8, p1795 

    Abstract: We previously reported our results at a minimum of three and seven years after use of a porous-coated acetabular metal shell in a consecutive series of 138 revision total hip arthroplasties. The current report presents the longer-term outcomes of these procedures, at fifteen to...

  • Cementless Acetabular Revision with the Harris-Galante Porous Prosthesis. Hallstrom, Brian R.; Golladay, Gregory J.; Vittetoe, David A.; Harris, William H. // Journal of Bone & Joint Surgery, American Volume;May2004, Vol. 86-A Issue 5, p1007 

    Revisions of the acetabular component of a total hip arthroplasty have a higher rate of complications, particularly loosening and dislocation, than do primary procedures. The purpose of this study, in which the results of a consecutive series of revisions performed with the Harris-Galante Porous...

  • The Patulous Proximal Femur. Cameron, Hugh U. // Orthopedics;Sep2005 Supplement, Vol. 28, ps1105 

    Patients with patulous proximal femurs who have hip revision surgery can be treated with reduction osteotomies or with large ingrowth sleeves used with proximally modular stems. Three hundred nine patients had hip revision with >5-years' follow-up (mean 8.6 years). Reduction osteotomies were...

  • The Use of Long Cemented Stems for Femoral Impaction Grafting in Revision Total Hip Arthroplasty. Sierra, Rafael J.; Charity, John; Tsiridis, Eleftherios; Timperley, John A.; Gie, Graham A. // Journal of Bone & Joint Surgery, American Volume;Jun2008, Vol. 90-A Issue 6, p1330 

    Background: Following revision total hip arthroplasty involving femoral impaction grafting, fractures usually have occurred distal to a standard-length stem in an area of weakened bone that was left inadequately supported. The purpose of the present study was to determine whether the use of a...

  • Look to constrained liners to treat patients with chronic hip dislocation after THA. Brockenbrough, Gina // Orthopedics Today;Oct2008, Vol. 28 Issue 10, p9 

    The article looks at using constrained total hip designs to treat dislocation in total hip arthroplasty. Mathias P.G. Bostrom, MD, noted the success rates using the Osteonics device but suggested options such as using Durasul, a Zimmer design which has an improved range of motion. Bostrom...

  • Revision total hip arthroplasty using the Zweymuller femoral stem. Matthew Oetgen; Michael Huo // Journal of Orthopaedics & Traumatology;Jun2008, Vol. 9 Issue 2, p57 

    Abstract Background  A variety of femoral stem designs have been reported to be successful in revision total hip arthroplasty without consensus as to optimal design. We evaluated the clinical and radiographic outcomes in a consecutive series of femoral revisions using a wedge-shape,...

  • A comparison of the validity and reliability of established bone stock loss classification systems and the proposal of a novel classification system. Parry, Michael C.; Whitehouse, Michael R.; Mehendale, Sanchit A.; Smith, Lindsay K.; Webb, Jason C.; Spencer, Robert F.; Blom, Ashley W. // Hip International;Jan-Mar2010, Vol. 20 Issue 1, p50 

    The classification and management of aseptic loosening of total hip arthroplasty remains a distinct challenge to the modern orthopaedic surgeon. The aim of this study was to assess the inter-observer and intra-observer reliability of commonly used classification systems for the assessment of...

  • Revision of failed hip resurfacing to total hip arthroplasty rapidly relieves pain and improves function in the early post operative period. Sandiford, Nemandra A.; Muirhead-Allwood, Sarah K.; Skinner, John A. // Journal of Orthopaedic Surgery & Research;2010, Vol. 5, p88 

    We reviewed the results of 25 consecutive patients who underwent revision of a hip resurfacing prosthesis to a total hip replacement. Revisions were performed for recurrent pain and effusion, infection and proximal femoral fractures. Both components were revised in 20 cases. There were 12 male...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics