Mid-Term Outcomes of Revision Hip Arthroplasty with Acetabular Augments

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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

Author for correspondence.
Email: yalta60@mail.ru

Andrey A. Korytkin — Cand. Sci. (Med.), head of Adult Orthopedics Department.

Nizhny Novgorod

Russian Federation

Ya. S. Novikova

Privolzhsky Research Medical University

Email: fake@neicon.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

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