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Mid-Term Outcomes of Revision Hip Arthroplasty with Acetabular Augments
- Authors: Korytkin A.A.1, Novikova Y.S.1, Kovaldov K.A.1, Korolev S.B.1, Zykin A.A.1, Gerasimov S.A.1, Gerasimov E.A.1
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Affiliations:
- Privolzhsky Research Medical University
- Issue: Vol 25, No 1 (2019)
- Pages: 9-18
- Section: Clinical studies
- Submitted: 07.05.2019
- Accepted: 07.05.2019
- Published: 07.05.2019
- URL: https://journal.rniito.org/jour/article/view/1169
- DOI: https://doi.org/10.21823/2311-2905-2019-25-1-9-18
- ID: 1169
Cite item
Abstract
Acetabular defects are a major obstacle to achieving good outcomes after revision hip arthroplasty. One way to deal with this problem is to use acetabular augments. We aimed to describe mid-term outcomes of revision hip arthroplasty using acetabular augments.
Materials and methods. We analyzed 85 cases (83 patients) of revision hip arthroplasty using acetabular augments performed during 2012-2018 period: 53 women and 30 men with average age of 57±13 years (25-79). Distribution of acetabular defects was: 51 cases — Paprosky IIIA, 17 cases — Paprosky IIIB, 12 cases — Paprosky IIB, 5 cases — Paprosky IIC. 14 patients had chronic pelvic discontinuity. Aseptic loosening was indication for the operation in 83 cases, periprosthetic hip fracture — 1, dislocation — 1. The amount of previously undregone ipsilateral hipsurgeries was 1 in 35 cases, 2 in 25 cases, 3 and more in 25 cases. Average follow-up period was 38±19 months (1-79).
Results. The average HHS score improved from 37±7 preoperatively to 73±9 after 3 months and to 80±11 after 12 months postoperatively (p = 0.001). Average VAS score improved from 7±2 preoperatively to 4±1 after 3 months and to 3±1 after 12 months postoperatively (p = 0.001). Stable acetabular fixation was achieved in each case according to X-ray findings at final follow-up. However, radiolucent lines were present around the cup in 10 cases (11.8 %) followed by no clinical evidence of aseptic loosening. Hip center of rotation was restored from 26.40±18.38 mm (4-75) preoperatively to 4.78±5.02 mm (0-20) postoperatively relatively to 0 point. Complications manifested in 9 out of 85 cases (10,6%). Distribution of complications was: periprosthetic joint infection in 6 cases, recurrent dislocation — 2, periprosthetic hip fracture — 1.7 patients required implant removal and exchange.
Conclusions. Good mid-term outcomes can be achieved using acetabular augments during hip revision surgery in setting of acetabular defects. Acetabular augments are a reliable option in case of Paprosky IIIB, IIIA defects and chronic pelvic discontinuity, providing good mechanical stability.
About the authors
A. A. Korytkin
Privolzhsky Research Medical University
Email: fake@neicon.ru
Andrey A. Korytkin — Cand. Sci. (Med.), head of Adult Orthopedics Department.
Nizhny Novgorod
РоссияYa. S. Novikova
Privolzhsky Research Medical University
Author for correspondence.
Email: novikova_jana@mail.ru
Yana S. Novikova — Cand. Sci. (Biol.), junior researcher.
Nizhny Novgorod
РоссияK. A. Kovaldov
Privolzhsky Research Medical University
Email: fake@neicon.ru
Kirill A. Kovaldov — PhD Student, orthopedic surgeon.
Nizhny Novgorod
РоссияS. B. Korolev
Privolzhsky Research Medical University
Email: fake@neicon.ru
Svyatoslav B. Korolev — Dr. Sci. (Med.), professor, head of Traumatology, Orthopedics and Military Field Surgery Department, orthopedic surgeon.
Nizhny Novgorod
РоссияA. A. Zykin
Privolzhsky Research Medical University
Email: fake@neicon.ru
Andrey A. Zykin — Cand. Sci. (Med.), orthopedic surgeon.
Nizhny Novgorod
РоссияS. A. Gerasimov
Privolzhsky Research Medical University
Email: fake@neicon.ru
Sergey A. Gerasimov — orthopedic surgeon.
Nizhny Novgorod
РоссияE. A. Gerasimov
Privolzhsky Research Medical University
Email: fake@neicon.ru
Evgeny A. Gerasimov — PhD Student.
Nizhny Novgorod
РоссияReferences
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