Mid-Term Outcomes of Revision Hip Arthroplasty with Acetabular Augments

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

Russian Federation

Ya. S. Novikova

Privolzhsky Research Medical University

Author for correspondence.
Email: novikova_jana@mail.ru

Yana S. Novikova — Cand. Sci. (Biol.), junior researcher.

Nizhny Novgorod

Russian Federation

K. A. Kovaldov

Privolzhsky Research Medical University

Email: fake@neicon.ru

Kirill A. Kovaldov — PhD Student, orthopedic surgeon.

Nizhny Novgorod

Russian Federation

S. 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

Russian Federation

A. A. Zykin

Privolzhsky Research Medical University

Email: fake@neicon.ru

Andrey A. Zykin — Cand. Sci. (Med.), orthopedic surgeon.

Nizhny Novgorod

Russian Federation

S. A. Gerasimov

Privolzhsky Research Medical University

Email: fake@neicon.ru

Sergey A. Gerasimov — orthopedic surgeon.

Nizhny Novgorod

Russian Federation

E. A. Gerasimov

Privolzhsky Research Medical University

Email: fake@neicon.ru

Evgeny A. Gerasimov — PhD Student.

Nizhny Novgorod

Russian Federation

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